Approach to congenital infections Quiz: Ace Your Exams
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A 4-week-old female infant delivered at 39 weeks via vaginal delivery is evaluated for jaundice and profuse nasal discharge in the pediatrician’s office. The mother had no prenatal care. Rupture of membranes occurred 12 hours before delivery, and delivery was uncomplicated. Temperature is 37°C (98.6°F), pulse is 127/min, respirations are 35/min, blood pressure is 73/47 mmHg, and oxygen saturation is 98% on room air. Weight is 2500 g, and body length is 50 cm. On physical examination, the patient has a moderate amount of mucopurulent nasal discharge. Eye exam is within normal limits. The patient appears jaundiced and has generalized lymphadenopathy. Abdominal exam reveals hepatosplenomegaly. Laboratory results are shown below. Congenital infection is suspected. Which of the following additional physical examination findings would be expected?
| Laboratory values | Results |
| Hemoglobin | 13 g/dL |
| White blood cells | 37,560 /μL |
| Platelets | 90,000 /μL |
| Total bilirubin | 15 mg/dL |
| Direct bilirubin | 0.5 mg/dL |
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