A neonate born at 34 weeks gestation is found to have intracranial calcifications on cranial ultrasound, chorioretinitis on ophthalmological examination, and hydrocephalus. CSF shows mild pleocytosis and elevated protein. The TORCH infection MOST likely responsible is:

• A Cytomegalovirus (CMV)
• B Congenital rubella
• C Toxoplasma gondii ✓
• D Herpes simplex virus

Explanation

The classic triad of congenital toxoplasmosis is hydrocephalus, chorioretinitis, and intracranial calcifications (characteristically diffuse and periventricular). CMV causes periventricular calcifications but is less commonly associated with hydrocephalus. Rubella causes cataracts, cardiac defects, and sensorineural hearing loss as its triad. The combination of hydrocephalus with chorioretinitis and diffuse calcifications strongly points to congenital toxoplasmosis.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.