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Congenital cytomegalovirus — RACP Paediatrics MCQ

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HardNeonatologyCongenital cytomegalovirusRACP Paediatrics

A term newborn has petechiae, hepatosplenomegaly and microcephaly. Cranial ultrasound reports periventricular calcification, and the hearing screen is abnormal. The mother recalls a mild febrile illness in early pregnancy. What is the most likely diagnosis?

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Correct answer: A — Congenital cytomegalovirus infection

Periventricular calcification, microcephaly, petechiae, hepatosplenomegaly and sensorineural hearing loss are classic for congenital CMV. Toxoplasmosis more often gives diffuse intracranial calcification with chorioretinitis and hydrocephalus. The teaching point is that urine or saliva CMV PCR should be obtained early, ideally within the first 3 weeks, to confirm congenital infection.

Reference: RCH Clinical Practice Guidelines; Therapeutic Guidelines (eTG): Antibiotic