A neonate is born to a mother with primary CMV infection at 12 weeks of gestation. The infant is small for gestational age and has hepatosplenomegaly, purpuric rash, and periventricular calcifications on head ultrasound. The most important long-term complication to monitor and counsel about is:

• A Progressive retinitis leading to blindness
• B Late-onset congenital heart disease
• C Progressive renal failure
• D Progressive sensorineural hearing loss — occurs in up to 50% of symptomatic and 10–15% of asymptomatic congenital CMV ✓

Explanation

Congenital CMV is the leading infectious cause of non-hereditary sensorineural hearing loss in children. It occurs in up to 50% of symptomatic neonates and importantly also in 10–15% of initially asymptomatic infected infants who can develop progressive hearing loss months to years later — hence serial audiological monitoring is mandatory. Progressive retinitis is characteristic of toxoplasmosis, not CMV.

Reference: Ghai Essential Pediatrics, 10th ed.

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Written and medically reviewed by the StethoPrep medical team.