Clinical Manifestations of Non-Congenital CMV Infection in Infants and Immunocompetent Children: Review of Cases from the Past Decade.

Cytomegalovirus (CMV), the largest of the herpes viruses, is a widespread virus that commonly infects people of all ages. CMV can cause a spectrum of clinical manifestations, ranging from asymptomatic infection to severe disease, particularly in immunocompromised hosts. However, postnatal and acquired CMV infections in immunocompetent children remain under-documented in the literature. In this review, we examine studies published over the past decade to explore the clinical manifestations of CMV infections in the pediatric population, focusing on the variety of symptoms and the severity with which the infection can present. Papers published between 1 January 2014 and 2 December 2024 were selected from PubMed/MEDLINE, Embase, Scopus, and Web of Science. The search was conducted using the following keywords: "cytomegalovirus", "child", and "immunocompetent". The target population ranged from 0 to 17 years of age, with congenital and perinatal infections excluded. Despite the clinical significance of CMV in immunocompetent infants and children, there is a lack of consensus on the use and duration of antiviral therapy. This article aims to enhance clinicians' understanding of the various presentations of CMV infection in immunocompetent children, with the goal of facilitating earlier diagnosis and appropriate management. The reviewed papers indicated that postnatal CMV results in liver symptoms in 67% of cases, followed by hematological disorders and gastrointestinal pathology. In older children, primary infection leads to liver disease in 51% of cases, with greater neurological and pulmonary involvement compared to that in infants. By highlighting the wide-ranging clinical effects of CMV, we hope to improve physicians' ability to recognize and subsequently treat this often overlooked condition in pediatric patients.