A neonate presents at birth with microcephaly, periventricular calcifications on CT, hepatosplenomegaly, petechiae, and chorioretinitis. Maternal serology shows primary infection in the first trimester. The most likely TORCH pathogen is:
- A Toxoplasma gondii
- B Cytomegalovirus (CMV) ✓
- C Rubella virus
- D Herpes simplex virus
Correct answer: B. Cytomegalovirus (CMV)
Explanation
Congenital CMV is the most common congenital infection and classically causes periventricular calcifications (unlike Toxoplasma which causes diffuse/basal ganglia calcifications), sensorineural hearing loss, microcephaly, petechiae/thrombocytopenia and chorioretinitis. Rubella causes cataracts, cardiac defects (PDA, PA stenosis), and deafness. Toxoplasma causes diffuse calcifications, hydrocephalus, and chorioretinitis. HSV typically presents with skin-eye-mouth disease or disseminated infection, rarely periventricular calcifications.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.