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Joseph Junewick, MD FACR
over 7 years ago
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Congenital Cytomegalovirus Infection

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Infectious-Inflammatory
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: US
Activities:
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History

Newborn with trisomy 21 and pancytopenia.


Case Images


Diagnosis

Congenital Cytomegalovirus Infection

Findings

US – Oblique coronal and sagittal transfontanel images demonstrate perilateral ventricular and thalamic calcifications.

Discussion

Congenital CMV infection is one of the most common congenital viral infections. Fetal infection results from transmission of the virus across the placenta. Fetal effects are most severe if when the mother experiences a primary infection and if the infection occurs early in development. Manifestation of CMV infection include microcephaly,loss, intracranial calcifications, hearing loss, hepatosplenomegaly, low birth weight, pneumonitis, and hematologic abnormalities. Imaging findings of congenital CMV infection include intracranial calcification, ventriculomegaly, white matter disease, neuronal migrational disorders, and microcephaly. Not all of these findings are seen in every patient, and abnormalities may range from mild to severe. Intracranial calcification is the most frequently reported imaging finding of congenital CMV infection, occurring in 34%–70% of patients. Calcification occurs most commonly in the periventricular regions but also within the basal ganglia and brain parenchyma. Absence of calcification should not exclude a diagnosis of congenital CMV infection. The presence of intracranial calcification in patients with congenital CMV infection is associated with developmental delays.

Reference

Fink KR, Thapa MM, Ishak GE et al. Neuroimaging of Pediatric Central Nervous System Cytomegalovirus Infection. RadioGraphics (2010); 30: 1779-1796.



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