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Congenital cytomegalovirus — RACP Paediatrics MCQ

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HardInfectious diseases and immunisationCongenital cytomegalovirusRACP Paediatrics

A term newborn is small for gestational age with petechiae, hepatosplenomegaly and failed newborn hearing screen. Cranial ultrasound shows periventricular calcifications. What is the most likely diagnosis?

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Correct answer: B — Congenital cytomegalovirus infection

Congenital CMV is suggested by growth restriction, petechiae, hepatosplenomegaly, sensorineural hearing concern and periventricular calcifications. Toxoplasmosis more typically causes diffuse intracranial calcification and chorioretinitis. Urine or saliva CMV PCR within three weeks confirms congenital infection.

Reference: RACP Knowledge Guides; Australian congenital CMV guidance