title: Congenital lymphocytic choriomeningitis virus infection: spectrum of disease.
abstract: OBJECTIVE
  Lymphocytic choriomeningitis virus (LCMV) is a human pathogen and an emerging neuroteratogen. When the infection occurs during pregnancy, the virus can target and damage the fetal brain and retina. We examined the spectrum of clinical presentations, neuroimaging findings, and clinical outcomes of children with congenital LCMV infection.
  
  
  METHODS
  Twenty children with serologically confirmed congenital LCMV infection were identified. The children underwent neuroimaging studies and were followed prospectively for up to 11 years.
  
  
  RESULTS
  All children with congenital LCMV infection had chorioretinitis and structural brain anomalies. However, the presenting clinical signs, severity of vision disturbance, nature and location of neuropathology, and character and severity of brain dysfunction varied substantially among cases. Neuroimaging abnormalities included microencephaly, periventricular calcifications, ventriculomegaly, pachygyria, cerebellar hypoplasia, porencephalic cysts, periventricular cysts, and hydrocephalus. The combination of microencephaly and periventricular calcifications was the most common neuroimaging abnormality, and all children with this combination had profound mental retardation, epilepsy, and cerebral palsy. However, others had less severe neuroimaging abnormalities and better outcomes. Some children had isolated cerebellar hypoplasia, with jitteriness as their presenting sign and ataxia as their principal long-term neurological dysfunction.
  
  
  CONCLUSIONS
  Congenital LCMV infection can have diverse presenting signs, neuroimaging abnormalities, and clinical outcomes. In the companion article to this study, we utilize an animal model to show that the clinical and pathological diversity in congenital LCMV infection is likely due to differences in the gestational timing of infection.
authors.affiliation: Department of Pediatrics, University of Iowa College of Medicine, Iowa City, IA 52242, USA. daniel-bonthius@uiowa.edu
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Bonthius
authors.forename: Rhonda
authors.initials: R
authors.lastname: Wright
authors.forename: Brian
authors.initials: B
authors.lastname: Tseng
authors.forename: Leslie
authors.initials: L
authors.lastname: Barton
authors.forename: Elysa
authors.initials: E
authors.lastname: Marco
authors.forename: Bahri
authors.initials: B
authors.lastname: Karacay
authors.forename: Paul D
authors.initials: PD
authors.lastname: Larsen
mesh_terms: D001921:Brain / Q000473:pathology*; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008216:Lymphocytic Choriomeningitis / Q000151:congenital* / Q000175:diagnosis*; D008297:Male