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? Image reproduced from Radiopedia

Cytomegalovirus (CMV), also known as human herpes 5, is a double-stranded DNA virus. It is usually asymptomatic in immunocompetent individuals, but can present with severe diseases in immunocompromised individuals such as those with HIV/AIDS. It can cause retinitis, esophagitis, and retinitis pneumonia. On microscopic examination, infected cells can present with characteristic "owl eye" inclusion bodies. CMV is spread through body fluids such as saliva, urine, and sexual contact but can also be spread via transplanted organs.

Cytomegalovirus

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