A neonate born at 36 weeks has bilateral congenital cataracts detected on routine red reflex examination. Which TORCH infection is most associated with bilateral cataracts alongside microphthalmia and cardiac defects (PDA, pulmonary artery stenosis), and what is the critical period during which maternal infection leads to this triad?
- A Congenital CMV; first 12 weeks of gestation
- B Congenital rubella; first 8 weeks of gestation (organogenesis) ✓
- C Congenital toxoplasmosis; any trimester equally
- D Congenital herpes simplex; peripartum transmission
Explanation
Congenital rubella syndrome (CRS) classically presents with the triad of cataracts (typically bilateral, pearly white nuclear cataracts), cardiac defects (PDA and pulmonary artery stenosis are most characteristic), and sensorineural deafness. The risk of severe defects is highest with infection in the first 8 weeks of gestation (>80% risk), corresponding to organogenesis. CMV causes periventricular calcifications, chorioretinitis, and sensorineural deafness but not the same cardiac triad. Toxoplasmosis produces the classic triad of chorioretinitis, intracranial calcifications, and hydrocephalus.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.