Congenital CMV

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]

Causes

The cause of congenital CMV is cytomegalovirus. For more information about the causative agent, click here.

Differentiating Congenital CMV from Other Congenital Infections

The most important congenital infections, which can be transmitted vertically from mother to fetus are the TORCH infections. These infections have overlapping features and hence, must be differentiated from congenital CMV infection:

Congenital Infection	Cardiac Findings	Skin Findings	Ocular Findings	Hepatosplenomegaly	Hydrocephaly	Microcephaly	Intracranial Calcifications	Hearing deficits
Cytomegalovirus (CMV)	✔	Petechiae Purpura	Chorioretinitis	✔	—	✔	Periventricular calcifications	✔
Toxoplasmosis	—	Petechiae Purpura Maculopapular rash	Chorioretinitis	✔	✔	✔	Diffuse intracranial calcifications	—
Treponema pallidum	—	Petechiae Purpura Maculopapular rash	Chorioretinitis Glaucoma	✔	—	—	—	—
Rubella	Patent ductus arteriosus (PDA) Pulmonary artery stenosis Coarctation of the aorta Myocarditis	Petechiae Purpura	Chorioretinitis Cataracts Glaucoma Microphthalmia	✔	✔	✔	—	✔
Herpes simplex virus (HSV)	Myocarditis	Petechiae Purpura Vesicles	Chorioretinitis	✔	✔	✔	—	✔
Parvovirus B19	Myocarditis	Petechiae Subcutaneous edema	Chorioretinitis Cataracts	✔	—	—	—	—

Ultrasound

Prenatal Ultrasound

Various findings may be seen during a routine prenatal ultrasound in a suspected case of congenital CMV infection. However, none of these findings are specific.

Anomaly	Possible Findings
Amniotic Fluid	Polyhydramnios Oligohydramnios
Placenta	Placental enlargement
General Fetal	Intrauterine growth restriction (IUGR) Fetal demise Fetal hydrops
Brain	Periventricular calcifications Periventricular echogenicity Cerebral ventriculomegaly Occipital horn anomalies Cerebellar hypoplasia Microcephaly
Heart	Cardiomegaly
Gastrointestinal/ Abdominal	Bowel hyperechogenicity Hepatosplenomegaly Hepatic calcifications Ascites