Cytomegalic Inclusion Disease of the Developing Fetus: A Potentially Preventable Cause of Congenital Mental Defect

Abstract

Infection after infancy by salivary gland virus produces an apparently harmless salivary cytomegaly, Huge inclusion bodies develop which equal nuclei in size. Specific antibodies appear in the serum.

The infection is a serious risk to the fetus when transmitted during early pregnancy, despite lack of clinical illness shown by the mother. Actively growing fetal tissues, especially those of brain and liver, show necrosis without reaction which progresses silently for up to six months before birth. Shortly after bjrth, a characteristic clinical picture may supervene which imitates “erythroblastosis fetalis” or “neonatal hepatitis.” The concurrent brain injury has a highly characteristic periventricular location. Full cerebral development is blocked, leading to mental defect, spasticity, micro or obstructive-hydrocephaly, sometimes recognizable at birth.