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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 20th 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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AIDS (acquired immunodeficiency syndrome)

Cytomegalovirus (CMV) p. 162

Blueberry muffin rash

cytomegalovirus p. 181

Cytomegalovirus (CMV)

AIDS retinitis p. 162

cholecystitis and p. 405

clinical significance p. 162

esophagitis and p. 386

HIV-positive adults p. 174

hyper-IgM syndrome and p. 115

immunodeficient patients p. 116

pneumonia p. NaN

retinitis and p. NaN

ToRCHeS infection p. 181

treatment p. 199

viral receptor p. 163


cytomegalovirus p. 174

Hearing loss p. 552

cytomegalovirus p. 181

Organ transplants

cytomegalovirus p. 183


cytomegalovirus p. 181

Seizures p. 535

cytomegalovirus p. 181


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.


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