# Congenital Cytomegalovirus in a Resource-Limited Setting: A Case Report

## TL;DR

This case report describes a neonate with congenital CMV infection in a resource-limited setting, highlighting diagnostic challenges and the need for increased awareness.

## Contribution

The paper presents a real-world case of congenital CMV in a low-resource context, emphasizing management and diagnostic difficulties.

## Key findings

- The neonate showed symptoms like jaundice, rash, and neurological abnormalities consistent with CMV.
- Treatment with valganciclovir led to clinical improvement, but follow-up was limited by non-compliance.
- The case highlights the lack of universal screening for CMV during pregnancy in resource-limited areas.

## Abstract

Diagnosing congenital cytomegalovirus (CMV) infection in neonates, particularly in developing countries with limited resources, can be challenging. This case report and literature review highlights the clinical presentation, diagnostic challenges, and management strategies associated with congenital CMV infection in a limited-resource setting.

A female neonate born at 37 weeks and weighing 1760 grams presented with jaundice, petechial rash, and ventriculomegaly detected on prenatal ultrasound. Diagnostic workup revealed splenomegaly, thrombocytopenia, and elevated bilirubin levels, prompting suspicion of CMV infection. Serological testing confirmed CMV antibodies in the neonate, indicating severe symptomatic primary congenital infection.

Imaging studies demonstrated colpocephaly with periventricular calcifications, consistent with CMV-related neurological abnormalities. Treatment with oral valganciclovir resulted in clinical improvement without adverse effects. However, follow-up was hindered by the mother's non-compliance.

This case underscores the importance of considering CMV in the differential diagnosis of neonatal jaundice and neurological abnormalities. Despite its prevalence and clinical impact, there is no consensus on universal screening during pregnancy. Strengthening preventative measures and increasing awareness are crucial steps in addressing congenital CMV infection's public health implications.