A neonate born at 32 weeks presents with bulging fontanelle, hepatosplenomegaly, purpuric rash ('blueberry muffin' lesions), and bilateral cataracts at birth. Maternal serology during pregnancy revealed low avidity IgG at 8 weeks. What is the most likely diagnosis?

• A Congenital rubella syndrome ✓
• B Congenital toxoplasmosis
• C Congenital cytomegalovirus infection
• D Congenital syphilis

Explanation

Congenital rubella syndrome (CRS) classically presents with the triad of cataracts, cardiac defects (PDA, pulmonary artery stenosis), and sensorineural deafness. 'Blueberry muffin' lesions represent dermal erythropoiesis from thrombocytopenic purpura and are characteristic of CRS. Low avidity rubella IgG in the first trimester indicates primary maternal infection during organogenesis. Congenital CMV more commonly causes periventricular calcifications, while toxoplasmosis causes diffuse intracranial calcifications.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.