A newborn has a “blueberry muffin” rash.

17-year-old primigravida Hispanic mother who recently emigrated from Mexico and received only late prenatal care

The mother denied any illness or rash during pregnancy and had no known sick contacts.

  ∙ Extramedullary dermal erythropoiesis

The infant was placed in isolation, and nasopharyngeal, conjunctival, and rectal swabs were obtained for viral studies. Both urine shell vial and viral culture were positive for human cytomegalovirus (CMV), which was confirmed on repeat testing. Although rubella infection also was a concern due to the mother’s nonimmune status, maternal and cord serologies for rubella were negative.

The patient received a packed red blood cell and platelet transfusion after the initial laboratory evaluation. He was weaned off of nasal cannula oxygen after several days. Echocardiography performed 1 day after delivery showed a normal heart, with small patent ductus arteriosus and patent foramen ovale. Liver enzymes and bilirubin values were...

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