infectious disease/cytomegalovirus

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686463876c78b8d82816dd5d

Pediatrics

infectious disease

cytomegalovirus

A 3-day-old female infant, born at 39 weeks' gestation via spontaneous vaginal delivery, is undergoing evaluation in the neonatal intensive care unit. Her mother, a G2P1, experienced an unspecified febrile illness with flu-like symptoms during the first trimester, for which she received no specific treatment or detailed investigation due to limited access to care. The infant's vital signs are: temperature 37.2°C, heart rate 140 beats/min, respiratory rate 45 breaths/min, and blood pressure 65/45 mmHg. On physical examination, diffuse purpuric lesions resembling a "blueberry muffin" rash are noted across the trunk and extremities, along with significant hepatosplenomegaly extending 3 cm below the costal margins. Fundoscopic examination reveals focal retinal scarring and areas of active inflammation. Neurological assessment shows subtle hypotonia and a weak suck reflex. Given these findings, what is the most likely underlying congenital infection and the appropriate initial therapeutic intervention?

Lab ParameterValueReference Range
Platelet Count70 x 10^9/L150-450 x 10^9/L
White Blood Cell Count18.5 x 10^9/L5.0-20.0 x 10^9/L (neonates)
Hemoglobin135 g/L140-200 g/L (neonates)
Direct Bilirubin50 µmol/L< 25 µmol/L
Alanine Aminotransferase (ALT)90 U/L< 40 U/L

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