Which congenital infection is classically associated with a blueberry muffin rash due to extramedullary hematopoiesis?

Which congenital infection is classically associated with a blueberry muffin rash due to extramedullary hematopoiesis?

• A. Cytomegalovirus
• B. Toxoplasmosis
• C. Rubella
• D. Syphilis

Answer: (A)

Blueberry muffin rash comes from extramedullary hematopoiesis in the fetus, where the liver and spleen produce blood cells in response to infection, resulting in nonblanching purpuric skin lesions after birth. The infection most classically linked to this finding is cytomegalovirus, a common congenital TORCH infection. CMV can disrupt normal hematopoiesis and lead to anemia and thrombocytopenia, with the skin showing these characteristic purpuric spots. In addition to the rash, congenital CMV often presents with findings such as microcephaly, periventricular calcifications, sensorineural hearing loss, hepatosplenomegaly, and jaundice. While other TORCH infections can also cause similar skin lesions, CMV is the classic association you’re tested on, making it the best answer.

Blueberry muffin rash comes from extramedullary hematopoiesis in the fetus, where the liver and spleen produce blood cells in response to infection, resulting in nonblanching purpuric skin lesions after birth. The infection most classically linked to this finding is cytomegalovirus, a common congenital TORCH infection. CMV can disrupt normal hematopoiesis and lead to anemia and thrombocytopenia, with the skin showing these characteristic purpuric spots. In addition to the rash, congenital CMV often presents with findings such as microcephaly, periventricular calcifications, sensorineural hearing loss, hepatosplenomegaly, and jaundice. While other TORCH infections can also cause similar skin lesions, CMV is the classic association you’re tested on, making it the best answer.