This patient’s symptoms of bilateral hearing loss, seizures, and imaging findings of periventricular calcifications and ventriculomegaly are most consistent with congenital cytomegalovirus (CMV) infection. Congenital CMV is the most common congenital viral infection and is the leading non-genetic cause of sensorineural hearing loss. Other symptoms commonly seen include intrauterine growth restriction, microcephaly, “blueberry muffin rash” (intradermal hematopoiesis), jaundice, and hepatosplenomegaly. Neuroimaging shows calcifications, periventricular cysts, ventricular dilation, and white matter abnormalities. Primary maternal infection can be identified using IgG and IgM serology. Amniocentesis for PCR of CMV DNA is the best available tool for diagnosing a fetal CMV infection. Treatment for congenital CMV infection is oral valganciclovir for 12 months.