Differential Diagnosis for Congenital Infection
- Single Most Likely Diagnosis
- A) Cytomegalovirus (CMV): This is the most likely diagnosis due to the combination of symptoms presented, including diffuse jaundice, petechial rash, sensorineural hearing loss, and the findings on the CT scan of the head, which are consistent with congenital CMV infection. CMV is a leading cause of congenital infection and can result in significant morbidity, including hearing loss, developmental delays, and vision impairment.
- Other Likely Diagnoses
- G) Toxoplasma gondii: Although less common than CMV, congenital toxoplasmosis can also present with similar symptoms, including jaundice, rash, and neurological findings. The presence of hepatosplenomegaly and the potential for sensorineural hearing loss could also fit with toxoplasmosis.
- D) Rubella: Congenital rubella syndrome, although rare in areas with widespread vaccination, can cause a constellation of symptoms including jaundice, petechiae, hepatosplenomegaly, and sensorineural hearing loss, making it a consideration in the differential diagnosis.
- Do Not Miss Diagnoses
- B) Listeria monocytogenes: While less likely to cause the specific combination of symptoms described, congenital listeriosis can lead to severe illness, including sepsis and meningitis, and is critical to identify due to its potential for high morbidity and mortality.
- E) Streptococcus agalactiae (Group B Streptococcus): This bacterium is a common cause of neonatal sepsis and meningitis, which could potentially present with some overlapping symptoms, and it is crucial to consider due to the severity of the disease it can cause.
- Rare Diagnoses
- C) Parvovirus B19: Typically associated with erythema infectiosum in children and aplastic crisis in individuals with hemoglobinopathies, congenital parvovirus B19 infection can cause hydrops fetalis but is less likely to present with the specific combination of symptoms described.
- F) S. intermedius: This bacterium is part of the Streptococcus milleri group and is more commonly associated with abscesses and other localized infections rather than congenital infections presenting with the described symptoms.