Extensive cystic encephalomalacia in an immunocompromised infant with congenital CMV and neonatal HSV infection

Brain MRI of a 1-year-old infant with cerebral palsy, seizure disorder, vision impairment, and developmental delays that resulted from congenital and neonatal viral infections in the setting of an underlying functional NK cell deficiency. The infant had both congenital CMV infection and neonatal HSV-2 encephalitis. The MRI demonstrates sequelae of encephalitis with extensive cystic encephalomalacia (seen in both panels A and B) involving bilateral cerebral hemispheres (left > right) and ventriculomegaly (seen best in panel A).