Cytomegalovirus Quiz: Ace Your Exams

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A 2-day-old male infant is evaluated in the neonatal intensive care unit after two episodes of seizures. The patient was delivered via vaginal delivery at 37-weeks gestational age. The mother received minimal prenatal care and experienced a flu-like illness and pharyngitis in the second trimester. Birth weight and head circumference are at the 20^th percentile. Temperature is 38.3°C (101°F), blood pressure is 84/52 mmHg, and pulse is 100/min. Physical examination is notable for petechiae and purpura over the arms, trunk, and legs. Abdominal examination reveals hepatosplenomegaly. Neuroimaging reveals the findings below. Which of the following additional physical examination findings is most likely present in this patient?

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Bilateral loss of red reflex

Diffuse swelling of the skin

Hemorrhage and necrosis of the retina

Continuous murmur over the left second intercostal space

Anterior bowing of the tibia