Congenital Cytomegalovirus Infection Masquerading as Antenatal Ventriculomegaly With Intraventricular Hemorrhage in a Term Neonate

Abstract

Intraventricular hemorrhage is an uncommon manifestation of congenital cytomegalovirus (CMV) infection and has been described in preterm neonates. We discuss a term neonate, who was referred because of intracranial hemorrhage and hydrocephalous detected in the antenatal ultrasound. She had cholestatic jaundice, hepatitis, and thrombocytopenia, with positive polymerase chain reaction for CMV. Neuroimaging revealed reduced sulcation, mildly enlarged ventricles, and multiple periventricular cysts, along with residual hemorrhage in occipital horn of left lateral ventricle. She was started on ganciclovir, following which there was improvement in platelet count, jaundice, as well as transaminase levels.

Non-neoplastic intracranial cystic lesions: not everything is an arachnoid cyst

“…It is more likely when maternal infection occurs in the first or second trimester of pregnancy, especially when it occurs in the first trimester. The imaging findings of congenital cytomegalovirus infection include microcephaly with ventriculomegaly, volume loss of white matter, delayed myelination, calcifications typically located in the periventricular region, and cysts, especially in the anterior temporal lobe ( 15 ) . A finding of cysts in the temporal lobe indicates a differential diagnosis that is quite common in the field of neuroradiology.…”