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Lymphocytic choriomeningitis virus: An under-recognized congenital teratogen
Thomas Ferenc1, Mateja Vujica2, Anna Mrzljak3,4
1Department of Radiology, Merkur University Hospital, Zagreb 10000, Croatia.
Background:
Lymphocytic choriomeningitis virus (LCMV) is a neglected rodent-borne arenavirus associated with transplacental transmission and fetal infection.
Aim:
To summarize the epidemiological, clinical, and diagnostic features of reported patients with congenital LCMV infection.
Methods:
A literature search was conducted in PubMed, Medline, Google Scholar, and ResearchGate. The keywords used were 'congenital lymphocytic choriomeningitis virus,' and 48 studies were included. In addition, we conducted a relevant search by Reference Citation Analysis (RCA) (https://www.referencecitationanalysis.com).
Results:
The results have shown 27 reports of congenital LCMV infection in 86 patients, with 52.73% of them being males. Patients presented with chorioretinitis (83.53%), hydrocephalus (54.12%), and psychomotor retardation or developmental delay (54.12%). Computed tomography and/or magnetic resonance imaging most often demonstrated ventriculomegaly (74.07%), periventricular calcifications (66.67%), and microcephaly (40%). Most mothers of congenitally infected infants were exposed to rodents during pregnancy, predominantly mice, with flu-like symptoms mainly occurring during the first two trimesters of gestation. Mortality in congenitally infected children was 16.47%. The diagnosis of congenital LCMV infection was confirmed serologically in most patients (86.67%).
Conclusion:
LCMV is still an insufficiently recognized fetal teratogen that often leads to long-term neurologic sequelae. Clinicians need to be familiar with LCMV and its potential teratogenic effect and as well as to effectively differentiate LCMV from other TORCH (T: Toxoplasma gondii, O: Other pathogens, R: Rubella virus, C: Cytomegalovirus, H: Herpes simplex virus) pathogens.
Insights
Lymphocytic choriomeningitis virus (LCMV) can cause congenital infections with severe outcomes like chorioretinitis and hydrocephalus. Early diagnosis and awareness are crucial for managing this underrecognized fetal teratogen.
Area of Science:
- Virology
- Infectious Diseases
- Obstetrics and Gynecology
Background:
- Lymphocytic choriomeningitis virus (LCMV) is a rodent-borne arenavirus.
- LCMV is known for transplacental transmission and causing fetal infections.
Purpose of the Study:
- To review and summarize epidemiological, clinical, and diagnostic aspects of congenital LCMV infection.
- To highlight the significance of LCMV as a teratogen.
Main Methods:
- Conducted a comprehensive literature search across PubMed, Medline, Google Scholar, and ResearchGate.
- Utilized keywords 'congenital lymphocytic choriomeningitis virus' and Reference Citation Analysis (RCA).
- Included 48 studies detailing cases of congenital LCMV infection.
Main Results:
- Identified 27 reports involving 86 patients with congenital LCMV infection; 52.73% were male.
- Common clinical presentations included chorioretinitis (83.53%), hydrocephalus (54.12%), and psychomotor retardation (54.12%).
- Neuroimaging revealed ventriculomegaly (74.07%), periventricular calcifications (66.67%), and microcephaly (40%). Maternal flu-like symptoms occurred primarily in the first two trimesters, often linked to rodent exposure.
Conclusions:
- Congenital LCMV infection remains an underrecognized cause of fetal abnormalities and long-term neurological deficits.
- Clinicians must be aware of LCMV's teratogenic potential and differentiate it from other TORCH infections.
- Serological confirmation is the primary diagnostic method for congenital LCMV.
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