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Abstract


We report an autopsy case of congenital cytomegalic inclusion disease that was
associated with massive periventricular calcification and hydrocephalus. The male boy
was born by cesarian section at 38 weeks of gestational age to a 28 year old mother
and was dead two hours after delivery because of respiratory difficulty Radiologic
findings showed characteristic linear periventricular calcification, being associated with
marked dilatation of the lateral ventricles.
At autopsy, the brain parenchyme became 0.4 §¯ in average thickness due to
obstructive hydrocephalus at aqueductal level. The inner surface of the lateral ventricle
showed grayish white granular appearance that could correspond to the calcification seen
on plain skull X-ray films. Although active ependymitis, destruction of the brain
parenchyma with dystrophic calcification and gliosis were noted, there was no
intranuclear inclusion. After scrutinizing many sections of various organs and tissue, we
could be able to demonstrate a few inclusion bodies, highly suggestive of cytomegalic
inclusion disease.
It was discussed that this case might suggest that intranuclear inclusions in
cytomegalovirus infection could be very difficult to find particularly when the infection
is in inactive phase despite the presence of tissue necrosis and calcification of the brain.

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