Congenital cytomegalovirus infection

A baby girl was delivered prematurely, at 30 weeks' gestation, by emergency cesarean section owing to deceleration and no acceleration on fetal heart-rate monitoring. In addition, she had severe intrauterine growth restriction, oligohydramnios, and increased peak systolic velocity of the middle cerebral artery on Doppler ultrasonography. The 39-year-old mother (gravida 7, para 5) had been well during the pregnancy. On examination, the neonate was found to have respiratory distress, an extensive rash (Panel A), and hepatomegaly. The rash consisted of purple-to-magenta, nonblanching macules that were 0.5 to 1.0 cm in diameter, as well as papules and petechiae covering her entire . . .