Question

A child presents with a fever and a rash. Urine examination showed cells with owl's eye appearance. What is the most likely diagnosis?

• A. Cytomegalovirus
• B. Epstein-Barr virus
• C. Herpes simplex virus
• D. Toxoplasma gondii

Answer 1

The Correct Option is A

The clinical scenario presented involves a child with fever and rash. On examining the urine, cells with an "owl's eye" appearance are observed. This particular description is highly suggestive of cytomegalovirus (CMV) infection. CMV is a member of the herpesviridae family and is known to cause symptomatic infections in children and immunocompromised individuals. The presence of cells with characteristic "owl's eye" inclusions, which are large cells containing viral inclusions in the nucleus, is a classic finding in CMV infections. Therefore, considering the options provided:

• Cytomegalovirus: Correct choice, as CMV is associated with the "owl's eye" appearance in infected cells.
• Epstein-Barr virus: Typically associated with infectious mononucleosis and does not produce "owl's eye" cells.
• Herpes simplex virus: Causes vesicular lesions and other symptoms but not "owl's eye" inclusions.
• Toxoplasma gondii: A protozoan causing toxoplasmosis with no association with "owl's eye" inclusions.

The most likely diagnosis, confirmed by the described appearance of cells in the urine, is cytomegalovirus infection.