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Diffuse periventricular calcification and brain atrophy: A case of neonatal central nervous system cytomegalovirus
Thomas R Sanchez1, Mitchell D Datlow2, Anna E Nidecker2
1Division of Pediatric Radiology, University of California, USA trsanchez@ucdavis.edu.
Insights
Neonatal cytomegalovirus infection, a common congenital issue, can cause serious neurological problems. This case highlights key imaging findings for diagnosis and prognosis in affected newborns.
Area of Science:
- Neonatology
- Infectious Diseases
- Medical Imaging
Background:
- Congenital cytomegalovirus (CMV) infection is a leading cause of congenital infections globally.
- It can lead to significant neurological morbidity, including hearing impairment and developmental delays.
Observation:
- A term neonate presented with ventriculomegaly, low birth weight, microcephaly, hepatosplenomegaly, and purpuric rash.
- Prenatal ultrasound detected ventriculomegaly, prompting further investigation.
Findings:
- Central nervous system (CNS) CMV infection often presents with periventricular calcifications, white matter damage, and ventriculomegaly.
- Diagnostic imaging modalities like ultrasound, CT, and MRI play crucial roles in identifying these features.
Implications:
- Distinctive imaging features of congenital CNS CMV aid in early diagnosis and work-up.
- Imaging findings can assist in predicting the prognosis for affected neonates.
Abstract:
TORCH refers to the most common congenitally acquired infections: toxoplasma, rubella, cytomegalovirus, and herpes simplex virus. Neonatal cytomegalovirus infection remains a common cause of congenital infection worldwide with effects ranging from hearing impairment to significant neurological morbidity. We report a case of a term neonate with ventriculomegaly on prenatal ultrasound who presented with low birth weight, small head circumference, hepatosplenomegaly, and purpuric rash on physical exam. Central nervous system cytomegalovirus infection typically shows periventricular calcifications and associated deep white matter damage and ventriculomegaly. Ultrasound, computed tomography, and magnetic resonance imaging have different roles in the diagnosis of congenital central nervous system cytomegalovirus infection. Many imaging features of congenital cytomegalovirus are distinctive, and can spur a diagnostic work-up as well as help provide a prognosis.
