Lymphocytic choriomeningitis virus: An under-recognized congenital teratogen

Table 1 List of reported congenital lymphocytic choriomeningitis virus infections

Country (year)	Cases, n	Clinical characteristics	CT/MRI imaging	Ref.
England (1955)	1	Fever, epilepsy-like symptoms, opisthotonus, intracranial hemorrhage, skin lesions, hydrocephalus	ND	Komrower et al[10], 1955
Germany (1974, 1999)	8 (2- twins)	Hydrocephalus, chorioretinitis, myopia, hyperbilirubinemia, developmental delay, heart failure, psychomotor retardation, epilepsy-like symptoms, dystrophia, microcephaly, visual impairment, intracranial calcifications	ND	Ackermann et al[11], 1974; Enders et al[37], 1999
Lithuania (1976, 1981)	22	Hydrocephalus, spastic quadriplegia, epilepsy-like symptoms, chorioretinitis, optic nerve atrophy, psychomotor retardation, blepharoptosis, microphthalmy, cataract, cerebral palsy, microcephaly	ND	Sheinbergas[12], 1976; Sheinbergas et al[38], 1981
France (1978, 2000, 2009, 2017)	6 (2- twins)1	Hydrocephalus, chorioretinitis, fetal hydrops, hepatosplenomegaly, cardiomegaly, microcephaly, abnormal gyration, cerebral atrophy, periventricular calcifications, ascites, anemia, thrombocythemia	MRI: normal	Chastel et al[13], 1978; Brézinet al[40], 2000; Meritet et al[39], 2009; Delaine et al[28], 2017
United States (1993, 1995-1997, 2000, 2002, 2003, 2006, 2007, 2013, 2014, 2017, 2018, 2021)	47 (3- twins)2	Microcephaly, optic nerve atrophy, nystagmus, chorioretinitis, developmental delay, hydrocephalus, microphthalmia, visual impairment, psychomotor retardation, periventricular calcifications, intracranial calcifications, nystagmus, exotropia, dolichocephaly, cortical thumb, skin lesions, spastic quadriplegia, epilepsy-like symptoms, esotropia, heart abnormality (single ventricle with pulmonary atresia), glaucoma, conjunctivitis, clinodactyly, hearing impairment, progressive supranuclear palsy, epilepsy, ataxia, spastic diplegia, fetal hydrops, ascites, cataract, retinal coloboma	CT: subependymal calcifications, cerebral atrophy, ventriculomegaly, ependymal calcifications, calcification of the lens, periventricular calcifications, shizencephaly, microcephaly, colpocephaly, encephalomalacia, gyral malformations, cerebellar dysgenesis, periventricular cysts, basal ganglia, and parenchymal calcifications MRI: ventriculomegaly and ventricular dysmorphology, cerebral atrophy, gyral malformations, corpus callosum atrophy, brain stem and cerebellum displacement, ‘migration disorder’, prominent cortical sulci, cortical lesions, cerebellar dysgenesis, agenesis of the corpus callosum colpocephaly, agenesis of the septum pellucidum, periventricular calcifications, microcephaly, encephalomalacia, porencephaly, periventricular cysts, fetal hydrops, ascites, intracranial hemorrhage, subependymal calcifications, porencephalic cysts	Larsen et al[14], 1993; Barton et al[41], 1993; Barton[42], 1995; Barton et al[43], 1996; Wright et al[17], 1997; Bechtel et al[44], 1997; Mets et al[24], 2000; Barton et al[45], 2002; Greenhow et al[25], 2003; Schulte et al[15], 2006; Yu et al[35], 2006; Bonthius et al[19], 2007; El Feghaly et al[27], 2013; Anderson et al[20], 2014; Bou Ghannam et al[46], 2017; Kinori et al[22], 2018; Ansari et al[47], 2021
Canada, 2015	2	Microcephaly, abnormal gyration, hydrocephalus, pontocerebellar hypoplasia	ND	Fallet-Bianco et al[48], 2015

¹Second twin clinically unremarkable, never examined serologically;

²Two pairs of twins: one twin was clinically unremarkable, serologically negative. CT: Computed tomography; MRI: Magnetic resonance imaging; ND: No data.

Table 2 Epidemiological and clinical features of maternal lymphocytic choriomeningitis virus infections

Characteristic	Prevalence
Rodent exposure	71.11%
Type of rodent
Mice	44.44%
Hamster	8.89%
Rat	4.44%
Mice + hamster	8.89%
Mice + rat	4.44%
Flu-like illness	60.71%
First symptoms (trimester)
First	27.27%
Second	33.33%
Third	6.06%
No symptoms	33.33%