Cytomegalovirus infection is classically associated with which fetal finding?

• A. Blueberry muffin rash
• B. Heterophile negative mononucleosis
• C. Periventricular calcifications
• D. Intracranial hemorrhage

Answer: (C)

Congenital cytomegalovirus infection is classically linked to calcifications around the ventricles of the brain. This pattern comes from viral injury to developing neural tissue near the ventricles, producing periventricular calcifications that are a hallmark seen on fetal imaging. Among the listed options, this periventricular calcification finding best distinguishes CMV from other congenital infections. While a blueberry muffin rash can be seen with CMV due to extramedullary hematopoiesis, and heterophile-negative mononucleosis describes a clinical syndrome in older individuals, those findings are not as characteristic for the fetal imaging hallmark of CMV. Intracranial hemorrhage is not the classic fetal feature of CMV.