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Journal of Pediatric Neurology 2017; 15(02): 076-079
DOI: 10.1055/s-0036-1597654
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Congenital Lymphocytic Choriomeningitis Virus in a Member of a Twin Pregnancy

Alaa Bou Ghannam
1   Children's National Health System, Washington, District of Columbia, United States
,
Taeun Chang
1   Children's National Health System, Washington, District of Columbia, United States
2   The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
,
Barbara A. Jantausch
1   Children's National Health System, Washington, District of Columbia, United States
2   The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
,
Gilbert Vézina
1   Children's National Health System, Washington, District of Columbia, United States
2   The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
,
Marijean Miller
1   Children's National Health System, Washington, District of Columbia, United States
2   The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, United States
› Author Affiliations
Further Information

Publication History

22 September 2016

14 November 2016

Publication Date:
26 December 2016 (online)

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Abstract

We report a male infant, twin A of a dichorionic pregnancy, with a fetal ultrasound and subsequent MRI at 29 weeks of gestation revealing a small cranium (26 cm, < 3rd percentile for gestation) and marked ex vacuo ventriculomegaly. Twin B had normal ultrasound and brain MRI. Newborn exam was unremarkable and his weight and head circumference were both at 5th percentile. Placental pathology findings included focal acute vasculitis and chronic villitis. Postnatal brain MRI showed significant cerebral volume loss with extensive large cystic parietal encephalomalacia and diffuse cerebral cortical dysplasia (polymicrogyria). Common congenital infectious diseases investigation on maternal serum was normal. Twin A was admitted for bronchiolitis and possible seizure at 3 months of age. At this time, he had microcephaly and was not tracking light. Ophthalmology exam showed markedly abnormal macula with diffuse pigment changes and scarring that extended between the full arcades bilaterally. Congenital lymphocytic choriomeningitis virus (LCMV) infection was confirmed with negative IgM titer and highly positive IgG titer of greater than 1:256. Serologic tests for LCMV should be considered in infants who have central nervous system and retinal involvement but negative TORCH studies.

Keywords

lymphocytic choriomeningitis virus - dichorionic diamniotic twin pregnancy - chorioretinitis - microcephaly - cystic encephalomalacia