Atypical Presentation of Congenital Cytomegalovirus Infection Mimicking Leukodystrophy: A Case Report

contrast was conducted at 4 months of age.Findings showed confluent T 2 hyperintensity in periventricular, deep white matter, and anterior temporal lobes; sparing of subcortical arcuate fibers (U-fibers); and small anterior temporal cysts, which were deemed most concerning for dys/demyelinating leukodystrophy (Figs 2A andC).Esotropia with suspected optic nerve hypoplasia was documented at 5 months; on reevaluation at 8 months, the deviation had evolved to intermittent exotropia, and the examination showed no optic atrophy, retinitis, or optic nerve hypoplasia.Progressive dysphagia necessitated gastrostomy (G)-tube placement at 25 months.Audiology demonstrated fluctuating middle ear function, which later resolved posttympanostomy tube placement.Around 20 months of age, a repeat MRI of the brain (MRI #2) was conducted (Figs 2B andD).Compared with MRI #1, white matter hyperintensity was mildly