By Gary M. White, MD
Courtesy Michael O. Murphy, MD
The blueberry muffin baby has red to purple spots at birth giving the appearance of a blueberry muffin. The blue areas represent dermal erythropoiesis most commonly as a result of congenital rubella, but also from infection with parvovirus B19 or CMV. Metastatic neuroblastoma may be causative.
Congenital infections are classic (TORCH infections, which include congenital rubella, toxoplasmosis, syphilis, enterovirus, parvovirus B19, and cytomegalovirus), but other causes include hemolytic conditions (hereditary spherocytosis, twin-twin transfusions), blood group incompatibility disorders (RH isoimmunization), and neoplastic diseases (neuroblastoma, langerhans cell histiocytosis, and congenital leukemia).
Multiple, scattered red to purple macules and nodules are present in an infant.
Workup and treatment should be carried out in conjunction with the pediatrician and infectious disease or other specialist.
All courtesy Michael O. Murphy, MD
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