Congenital cytomegalovirus infection: Three autopsy case reports

We report three autopsy cases of congenital cytomegalovirus (CMV) infection in fetuses with a review of literature. The clinical manifestations in the se cases of congenital CMV infection include intrauterine fetal death, hydr ops fetalis, and CMV pneumonia associated with cardiovascular defect. The p athological characteristics were as follows: 1) the kidney was the most fre quently involved organ, followed by lung and liver, 2) CMV inclusions were found predominantly in epithelial cells and to a lesser degree in endotheli al cells, 3) intrahepatic bile duct epithelial cells were frequently involv ed, and 4) inflammatory reaction around CMV inclusions was not prominent in the early stage of pregnancy. Diagnostic confirmation was obtained by in s itu hybridization (ISH) using a biotinylated CMV-DNA probe, which demonstra ted intranuclear inclusions and sometimes recognized cells that did not sho w intranuclear inclusion.