Symptomatic Congenital Cytomegalovirus Infection: Three Years MRI and Clinical Follow Up

Congenital cytomegalovirus infection affects about 1% of the live-born infants. Around 10% of children with congenital infection at birth have apparent disease, being symptomatic. The most common and prognostically unfavourable clinical sign is microcephaly, reflects disturbed brain development. We present brain magnetic resonance imaging findings of the girl performed at the age of 7 days, 12 months, and 2.5 years. MRI follow-up images showed that cortical dysgenesis (pachygyria) remained unchanged, whereas white matter abnormalities evolved over the years. From the beginning she had delayed motor milestones, sensorineural deafness on the left side and poor social contact. At the age of 3 years she showed severe neuromotor dysfunction, predictive of bilateral spastic palsy and severe mental impairment, absent language development, marked microcephaly, but no epilepsy so far. The aim of this study was to correlate brain structural abnormalities as visualized by serial MRI with neurodevelopmental outcome in child with symptomatic congenital CMV infection and try to connect onset of infection with the severity of structural abnormalities and neurodevelopmental outcome.