CT scan of 5 month old male showing paucity of white matter, gross hydrocephalus with periventricular calcification and patchygyria suggestive of congenital TORCH infection most likely CMV infection.
Cytomegalovirus infection may be acquired prenatally or perinatally. Signs at birth, if present, are intrauterine growth restriction, prematurity, microcephaly, jaundice, petechiae, hepatosplenomegaly, periventricular calcifications, chorioretinitis, and pneumonitis. Later in infancy, signs are pneumonia, hepatosplenomegaly, hepatitis, thrombocytopenia, and atypical lymphocytosis. Diagnosis is by virus isolation or serology. Treatment is supportive. Parenteral ganciclovir can prevent hearing deterioration, but its use remains controversial.
Differential diagnosis: TORCH infection, Congenital lymphocytic choriomeningitis, Pseudo-TORCH syndrome, Tuberous sclerosis.
Pseudo-torch syndrome: A rare genetic syndrome characterized by a small head, eye disease and brain abnormalities.