A newborn with intrauterine growth restriction is found to have hepatosplenomegaly, thrombocytopenic petechiae, chorioretinitis, and periventricular calcifications on cranial ultrasound. Which TORCH pathogen is the MOST likely cause?
- A Rubella virus
- B Toxoplasma gondii
- C Cytomegalovirus (CMV) ✓
- D Herpes simplex virus
Correct answer: C. Cytomegalovirus (CMV)
Explanation
Congenital CMV is the most common congenital infection and the leading non-genetic cause of sensorineural hearing loss. Periventricular calcifications are the hallmark of congenital CMV (as opposed to the diffuse, 'scatter' calcifications of toxoplasmosis). The combination of IUGR, hepatosplenomegaly, petechiae, chorioretinitis, and periventricular calcifications is classical for CMV. Rubella preferentially causes cardiac defects, cataracts, and deafness. Toxoplasma causes hydrocephalus with diffuse cerebral calcifications.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.