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Case Reports
. 2024 Jun 21;16(6):e62844.
doi: 10.7759/cureus.62844. eCollection 2024 Jun.

Congenital Cytomegalovirus in a Resource-Limited Setting: A Case Report

Philip J Bert  1   2 , Carlos A Narvaez Gaitan  3 , Vilma E Vasquez Vado  4
Affiliations
Case Reports

Congenital Cytomegalovirus in a Resource-Limited Setting: A Case Report

Philip J Bert et al. Cureus. .

Abstract

Diagnosing congenital cytomegalovirus (CMV) infection in neonates, particularly in developing countries with limited resources, can be challenging. This case report and literature review highlights the clinical presentation, diagnostic challenges, and management strategies associated with congenital CMV infection in a limited-resource setting. A female neonate born at 37 weeks and weighing 1760 grams presented with jaundice, petechial rash, and ventriculomegaly detected on prenatal ultrasound. Diagnostic workup revealed splenomegaly, thrombocytopenia, and elevated bilirubin levels, prompting suspicion of CMV infection. Serological testing confirmed CMV antibodies in the neonate, indicating severe symptomatic primary congenital infection. Imaging studies demonstrated colpocephaly with periventricular calcifications, consistent with CMV-related neurological abnormalities. Treatment with oral valganciclovir resulted in clinical improvement without adverse effects. However, follow-up was hindered by the mother's non-compliance. This case underscores the importance of considering CMV in the differential diagnosis of neonatal jaundice and neurological abnormalities. Despite its prevalence and clinical impact, there is no consensus on universal screening during pregnancy. Strengthening preventative measures and increasing awareness are crucial steps in addressing congenital CMV infection's public health implications.

Keywords: blueberry muffin syndrome; colpocephaly; congenital cytomegalovirus; high risk neonates; low resource setting; neonatal cholestasis; pediatrics & neonatology; perinatal infection; periventricular calcifications.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Widespread blue and purple maculopapular lesions typically seen in blueberry muffin baby syndrome
Figure 2
Figure 2. Head CT scan showing colpocephaly with multiple periventricular calcifications
See this image and copyright information in PMC

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