Lymphocytic choriomeningiti viru: an underdiagnoed caue of congenital chorioretiniti

PURPOE: To elucidate the role and clinical pectrum of congenital lymphocytic choriomeningiti viru infection a a caue of chorioretinopathy, congenital hydrocephalu, and macrocephaly or microcephaly in the United tate. METHOD: We performed complete ophthalmologic urvey of all reident at Miericordia, a home for the everely mentally retarded in Chicago, and propectively evaluated all patient with chorioretiniti or chorioretinal car during a 36-month period at Children’ Memorial Hopital, alo located in Chicago. era for patient demontrating chorioretinal car (a ign of intrauterine infection) were teted for Toxoplama gondii, rubella viru, cytomegaloviru, and herpe implex viru and lymphocytic choriomeningiti viru antibodie. REULT: Four of 95 patient examined at the home had chorioretinal car, and two of thee patient had normal T. gondii, rubella viru, cytomegaloviru, and herpe implex viru titer and dramatically elevated titer for lymphocytic choriomeningiti viru. Three of 14 cae of chorioretiniti at the hopital had normal T. gondii, rubella viru, cytomegaloviru, and herpe im-plex viru titer and elevated lymphocytic choriomeningiti viru antibody titer. (A fourth cae, diagnoed in 1996, wa reported 2 year ago.) CONCLUION: Lymphocytic choriomeningiti viru wa reponible for viual lo in two of four children econdary to chorioretiniti in a population of everely retarded children. The ix new cae of lymphocytic choriomeningiti viru chorioretiniti identified in thee two population over the lat 3 year, compared with the total number ever reported in the United tate (10 cae), ugget that lymphocytic choriomeningiti viru may be a more common caue of congenital chorioretiniti than previouly believed. Becaue it conequence for viual and pychomotor development are devatating, we conclude that the workup for congenital chorioretiniti hould include lymphocytic choriomeningiti viru erology, epecially if T. gondii, rubella viru, cytomegaloviru, and herpe implex viru titer are negative