Sequence and Timing of Intracranial Changes in Cytomegalovirus in Pregnancy: A Case Report and Literature Review

OʼSullivan, Cynthia; Arulkumaran, S.; Lakasing, Lorin; Jauniaux, Eric; Murphy, Keefe

doi:10.1155/2017/5928398

Cited by 4 publications

(8 citation statements)

References 20 publications

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“…This sign is typical of CMV infection, but has been reported in congenital toxoplasmosis too. 38 Choroid plexus cyst has been considered a sign of infection, but none of the fetuses in which this marker was detected had infection at birth: This confirms the mostly benign nature of this finding. 3941 Eye may be affected by CMV, but retinal or lens calcifications are poorly detectable in utero by US.…”

Section: Dsjuogmentioning

confidence: 56%

Fetal Central Nervous System and Infectious Diseases

Masini¹,

Apicella²,

Luca³

et al. 2016

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Maternal infectious diseases are frequent complications of pregnancy and can cause negative outcomes. Perinatal infections can cause serious damage to fetal central nervous system (CNS), but incidence of symptomatic congenital infections at birth is low. Complete and multidisciplinary (obstetric, infectologist, microbiologist, neonatologist/pediatrician, psychologist) evaluation of the pregnant women is crucial to define fetal prognosis. The ultrasound (US) surveillance has an irreplaceable role in identifying serious fetal damage and complications. Complete evaluation of the fetus in selected cases needs to be integrated with invasive prenatal diagnosis, particularly amniocentesis, which has optimal predictive values in excluding vertical transmission, and fetal magnetic resonance imaging (MRI), which can add important anatomical detail when fetal CNS damage is suspected. Congenital infections, furthermore, need to be considered in differential diagnosis of some common abnormal CNS findings at prenatal US. With the present review, we intend to provide an overview of the major perinatal infections and the role of US diagnosis in their assessment to recognize fetal CNS damage. We highlight the most recognizable syndromes due to congenital infections by linking etiopathogenesis with pathology and imaging. In particular, we focus on US diagnostic and prognostic values in relation to other invasive and noninvasive prenatal diagnosis options and summarize up-to-date recommendations on US evaluation of most common findings. Cytomegalovirus (CMV) is the most common cause of congenital infection, while Toxoplasmosis is the most preventable cause of infectious CNS damage; rubella, varicella virus, and herpes viruses, even if rarely, may be responsible for extremely serious fetal damage, while Zika virus is an emerging concern on global scale. How to cite this article Masini L, Apicella M, De Luca C, Valentini P, Manfredi R, Lanzone A, De Santis M. Fetal Central Nervous System and Infectious Diseases. Donald School J Ultrasound Obstet Gynecol 2017;11(4):314-327.

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Section: Dsjuogmentioning

confidence: 56%

Fetal Central Nervous System and Infectious Diseases

Masini¹,

Apicella²,

Luca³

et al. 2016

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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show abstract

“…Infected women often present with nonspecific signs and symptoms, but the majority is asymptomatic. Approximately 10% of new borns show symptoms at birth but this increases to 20% to 30% if their mothers were infected in the first trimester [6]. In this case, the mother was asymptomatic.…”

Section: Discussionmentioning

confidence: 95%

“…This study presents a 24-year-old male case diagnosed with congenital CMV infection while following the patient with the case of cerebral palsy, mental retardation and epilepsy diagnosis. Due to the increase in the frequency of attacks, the patient's Brain CT calcifications and Anti CMV IgG 207 [5][6][7][8] were examined.…”

Section: Introductionmentioning

confidence: 99%

Congenital Cytomegalovirus Infection Diagnosis Case 24 Years Later While Following With The Cerebral Palsy Diagnosis

Aras¹

2017

J Neuroinfect Dis

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Cytomegalovirus (CMV) is the most common cause of intrauterine infection, occurring in upto 2% of all live births. Most women are asymptomatic or experience nonspecific symptoms, which can lead to long-term sequelae in newborns including neurological impairment, hearing loss, and mental retardation. In this study, the reveal of congenital CMV diagnosed after the calcification in the brain upon the increasing number of attacks in brain during the treatment with the diagnosis of cerebral palsy, mental retardation and epilepsy is presented.

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“…CMV IgG avidity was noted to be low and the possibility of congenital CMV infection was suspected. At 22 weeks, a repeat ultrasound still revealed only isolated echogenic bowel but only 5 days later, extensive cerebral abnormalities were noted revealing a poor prognosis [17].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic challenges in congenital cytomegalovirus infection in pregnancy: A case report

Mathias

Joung

2019

Case Reports in Women's Health

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Cytomegalovirus is the most common congenital viral infection. Infection can cause developmental delay, sensorineural deafness and fetal death. Fetal damage is more severe when infection occurs in the first trimester of pregnancy. Prenatal ultrasound findings may be cerebral, such as ventriculomegaly, microcephaly and periventricular leukomalacia, as well as non-cerebral, such as echogenic bowel, ascites and pericardial effusion. We present a case of congenital cytomegalovirus infection in which the only ultrasound sign noted at routine second-trimester scan was low-grade echogenic bowel, a soft marker, which progressed to severe disease in the third trimester, when further investigation was prompted, leading to the diagnosis. Patients need to be counselled regarding the possible perinatal prognosis. Ultrasound markers can often but not always predict severity and, hence, counselling can be a challenge. Conclusion: A meticulous anatomy survey in mid-trimester remains the norm and ultrasound soft markers should prompt comprehensive testing for viral infections in pregnancy.

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Sequence and Timing of Intracranial Changes in Cytomegalovirus in Pregnancy: A Case Report and Literature Review

Cited by 4 publications

References 20 publications

Fetal Central Nervous System and Infectious Diseases

Fetal Central Nervous System and Infectious Diseases

Congenital Cytomegalovirus Infection Diagnosis Case 24 Years Later While Following With The Cerebral Palsy Diagnosis

Diagnostic challenges in congenital cytomegalovirus infection in pregnancy: A case report

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