A term neonate has petechial rash, hepatosplenomegaly, jaundice and thrombocytopenia. CT head shows periventricular calcification and the newborn fails newborn hearing screening. The most likely cause of this congenital infection is:

• A Rubella virus
• B Toxoplasma gondii
• C Treponema pallidum
• D Cytomegalovirus ✓

Explanation

Congenital CMV is the most common congenital viral infection and characteristically produces periventricular calcifications, microcephaly, petechial blueberry muffin rash, and sensorineural deafness. Calcification location is the discriminating point: Toxoplasma causes diffuse intracranial calcifications, so the periventricular pattern plus hearing loss favors CMV over the strongest distractor. Congenital rubella gives cataracts, patent ductus arteriosus and deafness, and syphilis gives osteochondritis and snuffles.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.