Approach to congenital infections Quiz: Ace Your Exams

A 4-week-old female infant delivered at 37 weeks via an uncomplicated vaginal delivery is brought to the pediatrician's office for evaluation of a rash. The pregnancy was uncomplicated. Rupture of membranes occurred 8 hours before delivery, and delivery was uncomplicated. The mother had no exposure to pets during the pregnancy and did not use recreational substances. Apgar scores were 7 and 8 at one and five minutes, respectively. Temperature is 37°C (98.6°F), pulse is 138/min, respirations are 30/min, blood pressure is 68/39 mmHg, and oxygen saturation is 100% on room air. Weight is at the 5^th percentile, body length is at the 15^th percentile, and head circumference is at the 15^th percentile. On examination of the skin, there is a diffuse purplish-red rash. An image of the child’s eyes is shown below. Cardiac exam reveals a continuous machine-like murmur. Pulmonary and abdominal exams are normal. Which of the following organisms is the most likely cause of the findings in this patient?