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Congenital CMV
Surjith Vattoth, MD, FRCR; Miral D. Jhaveri, MD; Gary L. Hedlund, DO
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Congenital cytomegalovirus (CMV)
              • Synonyms

                • Human cytomegalovirus (HCMV)
              • Definitions

                • Congenital infection caused by transplacental transmission of CMV, member of herpes virus family
                  • Most common cause of intrauterine infection in USA

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Pathirana J et al: Prevalence of congenital cytomegalovirus infection and associated risk of in-utero HIV acquisition in a high HIV prevalence setting, South Africa. Clin Infect Dis. ePub, 2019
                                                2. Society for Maternal-Fetal Medicine (SMFM). et al: diagnosis and antenatal management of congenital cytomegalovirus infection. Am J Obstet Gynecol. 214(6):B5-11, 2016
                                                3. Capretti MG et al: Role of cerebral ultrasound and magnetic resonance imaging in newborns with congenital cytomegalovirus infection. Brain Dev. 36(3):203-11, 2014
                                                4. Alarcon A et al: Clinical, biochemical, and neuroimaging findings predict long-term neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection. J Pediatr. 163(3):828-34, 2013
                                                5. Fink KR et al: Neuroimaging of pediatric central nervous system cytomegalovirus infection. Radiographics. 30(7):1779-96, 2010
                                                6. Lanari M et al: Neuroimaging in CMV congenital infected neonates: how and when. Early Hum Dev. 88 Suppl 2:S3-5, 2012
                                                7. Manara R et al: Brain magnetic resonance findings in symptomatic congenital cytomegalovirus infection. Pediatr Radiol. 41(8):962-70, 2011
                                                8. Malinger G et al: Imaging of fetal cytomegalovirus infection. Fetal Diagn Ther. 29(2):117-26, 2011
                                                9. O'Driscoll MC et al: Recessive mutations in the gene encoding the tight junction protein occludin cause band-like calcification with simplified gyration and polymicrogyria. Am J Hum Genet. 87(3):354-64, 2010
                                                10. Benoist G et al: Cytomegalovirus-related fetal brain lesions: comparison between targeted ultrasound examination and magnetic resonance imaging. Ultrasound Obstet Gynecol. 32(7):900-5, 2008
                                                11. Briggs TA et al: Band-like intracranial calcification with simplified gyration and polymicrogyria: a distinct "pseudo-TORCH" phenotype. Am J Med Genet A. 146A(24):3173-80, 2008
                                                12. Picone O et al: Comparison between ultrasound and magnetic resonance imaging in assessment of fetal cytomegalovirus infection. Prenat Diagn. 28(8):753-8, 2008
                                                13. Ancora G et al: Cranial ultrasound scanning and prediction of outcome in newborns with congenital cytomegalovirus infection. J Pediatr. 150(2):157-61, 2007
                                                14. Malm G et al: Congenital cytomegalovirus infections. Semin Fetal Neonatal Med. 12(3):154-9, 2007
                                                15. de Vries LS et al: The spectrum of cranial ultrasound and magnetic resonance imaging abnormalities in congenital cytomegalovirus infection. Neuropediatrics. 35(2):113-9, 2004
                                                16. van der Knaap MS et al: Pattern of white matter abnormalities at MR imaging: use of polymerase chain reaction testing of Guthrie cards to link pattern with congenital cytomegalovirus infection. Radiology. 230(2):529-36, 2004
                                                17. Modlin JF et al: Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 25-2003. A newborn boy with petechiae and thrombocytopenia. N Engl J Med. 349(7):691-700, 2003
                                                18. Bale JF Jr: Congenital infections. Neurol Clin. 20(4):1039-60, vii, 2002
                                                19. Wright R et al: Congenital lymphocytic choriomeningitis virus syndrome: a disease that mimics congenital toxoplasmosis or Cytomegalovirus infection. Pediatrics. 100(1):E9, 1997
                                                20. Barkovich AJ et al: Congenital cytomegalovirus infection of the brain: imaging analysis and embryologic considerations. AJNR Am J Neuroradiol. 15(4):703-15, 1994
                                                21. Boesch C et al: Magnetic resonance imaging of the brain in congenital cytomegalovirus infection. Pediatr Radiol. 19(2):91-3, 1989
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Abbreviations

                                                              • Congenital cytomegalovirus (CMV)
                                                            • Synonyms

                                                              • Human cytomegalovirus (HCMV)
                                                            • Definitions

                                                              • Congenital infection caused by transplacental transmission of CMV, member of herpes virus family
                                                                • Most common cause of intrauterine infection in USA

                                                            IMAGING

                                                            • General Features

                                                              • Radiographic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Ultrasonographic Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Pathirana J et al: Prevalence of congenital cytomegalovirus infection and associated risk of in-utero HIV acquisition in a high HIV prevalence setting, South Africa. Clin Infect Dis. ePub, 2019
                                                                                              2. Society for Maternal-Fetal Medicine (SMFM). et al: diagnosis and antenatal management of congenital cytomegalovirus infection. Am J Obstet Gynecol. 214(6):B5-11, 2016
                                                                                              3. Capretti MG et al: Role of cerebral ultrasound and magnetic resonance imaging in newborns with congenital cytomegalovirus infection. Brain Dev. 36(3):203-11, 2014
                                                                                              4. Alarcon A et al: Clinical, biochemical, and neuroimaging findings predict long-term neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection. J Pediatr. 163(3):828-34, 2013
                                                                                              5. Fink KR et al: Neuroimaging of pediatric central nervous system cytomegalovirus infection. Radiographics. 30(7):1779-96, 2010
                                                                                              6. Lanari M et al: Neuroimaging in CMV congenital infected neonates: how and when. Early Hum Dev. 88 Suppl 2:S3-5, 2012
                                                                                              7. Manara R et al: Brain magnetic resonance findings in symptomatic congenital cytomegalovirus infection. Pediatr Radiol. 41(8):962-70, 2011
                                                                                              8. Malinger G et al: Imaging of fetal cytomegalovirus infection. Fetal Diagn Ther. 29(2):117-26, 2011
                                                                                              9. O'Driscoll MC et al: Recessive mutations in the gene encoding the tight junction protein occludin cause band-like calcification with simplified gyration and polymicrogyria. Am J Hum Genet. 87(3):354-64, 2010
                                                                                              10. Benoist G et al: Cytomegalovirus-related fetal brain lesions: comparison between targeted ultrasound examination and magnetic resonance imaging. Ultrasound Obstet Gynecol. 32(7):900-5, 2008
                                                                                              11. Briggs TA et al: Band-like intracranial calcification with simplified gyration and polymicrogyria: a distinct "pseudo-TORCH" phenotype. Am J Med Genet A. 146A(24):3173-80, 2008
                                                                                              12. Picone O et al: Comparison between ultrasound and magnetic resonance imaging in assessment of fetal cytomegalovirus infection. Prenat Diagn. 28(8):753-8, 2008
                                                                                              13. Ancora G et al: Cranial ultrasound scanning and prediction of outcome in newborns with congenital cytomegalovirus infection. J Pediatr. 150(2):157-61, 2007
                                                                                              14. Malm G et al: Congenital cytomegalovirus infections. Semin Fetal Neonatal Med. 12(3):154-9, 2007
                                                                                              15. de Vries LS et al: The spectrum of cranial ultrasound and magnetic resonance imaging abnormalities in congenital cytomegalovirus infection. Neuropediatrics. 35(2):113-9, 2004
                                                                                              16. van der Knaap MS et al: Pattern of white matter abnormalities at MR imaging: use of polymerase chain reaction testing of Guthrie cards to link pattern with congenital cytomegalovirus infection. Radiology. 230(2):529-36, 2004
                                                                                              17. Modlin JF et al: Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 25-2003. A newborn boy with petechiae and thrombocytopenia. N Engl J Med. 349(7):691-700, 2003
                                                                                              18. Bale JF Jr: Congenital infections. Neurol Clin. 20(4):1039-60, vii, 2002
                                                                                              19. Wright R et al: Congenital lymphocytic choriomeningitis virus syndrome: a disease that mimics congenital toxoplasmosis or Cytomegalovirus infection. Pediatrics. 100(1):E9, 1997
                                                                                              20. Barkovich AJ et al: Congenital cytomegalovirus infection of the brain: imaging analysis and embryologic considerations. AJNR Am J Neuroradiol. 15(4):703-15, 1994
                                                                                              21. Boesch C et al: Magnetic resonance imaging of the brain in congenital cytomegalovirus infection. Pediatr Radiol. 19(2):91-3, 1989