Congenital TORCH infections Quiz: Ace Your Exams

A 6-day-old male infant is brought to the emergency department after an episode of generalized seizure. He has also experienced lethargy and poor feeding. The mother had limited access to prenatal care. The patient was delivered at home by a midwife. During the third trimester of pregnancy, the mother developed multiple painful genital lesions that persisted until labor. Temperature is 40.1°C (104.2°F), blood pressure is 70/50 mmHg, pulse is 140/min, and respiratory rate is 37/min. Weight is at the 20^th percentile, and head circumference is at the 40^th percentile. The anterior fontanelle is open, and facial features appear normal. Ulcerative lesions are present over the tongue and oral mucosa. Examination of the skin is shown below. A lumbar puncture is performed, and cerebrospinal fluid analysis is notable for mononuclear pleocytosis and an elevated protein level. Which of the following agents is most likely responsible for this patient's presentation?
   ^{Image reproduced from CDC Public Health Library}