Rubella
Congenital rubella syndrome is not a frequent cause of congenital microcephaly. Microcephaly usually develops during infancy. Congenital rubella presents with cardiac disease (peripheral pulmonary stenosis, patent ductus arteriosus, and myocardial necrosis); ocular abnormalities (cataracts, salt and pepper chorioretinitis, and microphthalmia); and deafness. Congenital rubella syndrome is most likely to occur in neonates infected in the first trimester of pregnancy. Seizures and irritability may also be present. Cerebrospinal fluid pleocytosis is present in most patients. The diagnosis is established by specific serum IgM-enzyme-linked immunosorbent assay.