A 22-year-old woman comes to the office for a routine prenatal visit. She is 16 weeks pregnant with her first child. Two months ago, she had a mononucleosis-like illness with fever, myalgia, and fatigue, and she was diagnosed with cytomegalovirus infection. The patient recovered with symptomatic treatment and is currently asymptomatic. Her other medical problems include episodic migraine headaches and benign choroidal nevus. She takes prenatal vitamins and does not use tobacco, alcohol, or illicit drugs. The patient has a family history of hypertension and glaucoma. Physical examination findings and prenatal ultrasound are unremarkable. This patient's unborn infant is at greatest risk for which of the following eye conditions?

Question

A 22-year-old woman comes to the office for a routine prenatal visit.  She is 16 weeks pregnant with her first child.  Two months ago, she had a mononucleosis-like illness with fever, myalgia, and fatigue, and she was diagnosed with cytomegalovirus infection.  The patient recovered with symptomatic treatment and is currently asymptomatic.  Her other medical problems include episodic migraine headaches and benign choroidal nevus.  She takes prenatal vitamins and does not use tobacco, alcohol, or illicit drugs.  The patient has a family history of hypertension and glaucoma.  Physical examination findings and prenatal ultrasound are unremarkable.  This patient's unborn infant is at greatest risk for which of the following eye conditions?

Quizplus · Accepted Answer

Up to 5% of women develop a primary cytomegalovirus (CMV) infection (typically a mononucleosis-like illness with fever and mild hepatitis) during pregnancy. Vertical transmission to the fetus occurs in approximately one-third of cases, with the highest risk of transmission occurring in the first trimester. CMV-related complications observed in infants exposed to the virus in utero include chorioretinitis (most common eye-related problem), sensorineural deafness, seizures, jaundice, hepatomegaly, splenomegaly, and microcephaly. (Choice B) Choroidal nevus (eye freckle) is a nonhereditary, usually benign pigmented area underneath the retina and is not associated with in-utero CMV infection. (Choice C) Congenital cataract can be seen with in-utero rubella infection. (Choice D) Glaucoma can be present at birth and may be primary or secondary (eg, tumor). However, it is not a known complication of CMV infection. (Choice E) Inclusion conjunctivitis is seen with Chlamydia trachomatis infection of the newborn. (Choice F) Retinitis pigmentosa is an inherited degenerative eye disease that leads to severe vision impairment and is not a complication of in-utero CMV infection. (Choice G) Retinoblastoma is the most common malignant eye cancer in children and is caused by a chromosomal mutation that is hereditary or sporadic. CMV infection in utero is not associated with causing retinoblastoma. Educational objective: The most common eye-related complication of congenital cytomegalovirus infection is chorioretinitis. __________ References: Ocular abnormalities in congenital cytomegalovirus infection. (http://www.ncbi.nlm.nih.gov/pubmed/8888845)

A 22-Year-Old Woman Comes to the Office for a Routine