210 Congenital Cytomegalovirus (CMV) Infection and Agenesis of Corpus Callosum

Abstract

Background: Congenital CMV infection is associated with a wide spectrum of neuropathology, ranging from inflammation to destruction and malformation. Disturbances of neuronal migration with polymicrogyria involving cerebellar and cerebral cortex, lissencephaly, pachygyria, and schizencephaly have been observed. We present a newborn with congenital CMV infection exhibiting agenesis of the corpus callosum. Case presentation: Prenatal ultrasound at 32 wks gestational age showed corpus callosum agenesis in the fetus. Subsequent serologic tests detected primary CMV infection in the pregnant woman. The 2530g-girl was delivered at 39 wks. Besides a dysmorphic face with hypertelorism, no other anomalies were noted. Results: Serology confirmed CMV infection, but CMV early antigen was negative and PCR for DNA positive in only one of several urine specimens indicating that infection was no longer active. Utrasound of the brain showed agenesis of the corpus callosum and hypoplasia of the vermis. MR additionally detected pachygyria. There was no CMV-retinitis and auditory brain stem responses were normal. Clinically, the girl showed feeding difficulties. Conclusion: This is only the second report of corpus callosum agenesis in a newborn infant with congenital CMV infection. As the corpus callosum develops at approximately 10 weeks of gestation, the primary infection probably occurred in the first trimester, disturbing differentiation and migration of neuronal precursor cells.