Blueberry muffin baby with cytomegalovirus hepatitis

Infectious exanthemas in childhood

“…Congenital CMV infection may result in “blueberry muffin syndrome”, presenting with reddish‐blue purpuric macules, papules and/or nodules. This requires immediate diagnostic investigation due to extramedullary erythropoiesis [66]. Blueberry muffin syndrome is most commonly caused by congenital infection, especially with herpes viruses (CMV, herpes simplex) and rubella viruses, or less frequently by treponema pallidum and toxoplasma gondii .…”

“Blueberry muffin”: Manifestación atípica de una infección congénita frecuente

“…Típicamente se ha asociado a anemia crónica como un mecanismo de compensación 9 . El caso presentado representa la infección congénita más común a nivel global, sin embargo, las manifestaciones cutáneas se presentan en menos de 5% de los pacientes, y el síndrome "blueberry muffin" representa la dermatosis menos frecuente de todas las lesiones posiblemente observadas 10,11 .…”

Maculopapular rash in an infant

“…Non-infective causes of blueberry muffin-like lesions include hereditary spherocytosis, ABO-Rh incompatibility, twin-twin transfusion, congenital leukaemia, neonatal neuroblastoma, congenital alveolar rhabdomyosarcoma, neonatal lupus erythematosus and congenital Langerhans cell histiocytosis. 1,2 On histopathology, the reticular dermis contains aggregates of nucleated and non-nucleated erythrocyte precursors, but generally no cells of myeloid/ megakaryocytic type. 3 Although, blueberry muffin baby has been historically associated with intra-uterine infections and haematologic dyscrasias, the differential diagnosis should be expanded to include several neoplastic and vascular disorders as well.…”