Congenital rubella syndrome physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]

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Overview

Congenital rubella syndrome is characterized by triad of sensorineural deafness, eye abnormalties (cataracts, retinopathy) and heart defects (PDA).

Physical Examination

Congenital rubella syndrome affects multiple organ systems. The classic triad of congenital rubella syndrome consists of cataracts, sensorineural hearing loss and patent ductus arteriosus (PDA). However, many other findings are evident on physical examination and these include:

Organ System	Findings	Suggestive of
General Appearance	Low birth weight
Skin	Skin lesions of several sizes (petechiae and purpura)	Thrombocytopenic purpura
	Yellow discoloration of the skin and mucous membranes	Obstructive jaundice
Eyes	Clouding of the corneas	Cataracts
		Congenital glaucoma
		Pigmentary retinopathy
	Yellow discoloration of the sclera	Obstructive jaundice
Ears		Sensorineural hearing loss
Heart	Holosystolic murmur, best heard at the left lower sternal border	Ventricular septal defect (VSD)
	Continuous, machinery murmur, best heard at the left infraclavicular area	Patent ductus arteriosus (PDA)
	Midsystolic murmur, best heard at the left infraclavicular area Continuous murmur due to the formation of collaterals	Coarctation of the aorta
		Pulmonary artery stenosis
Abdomen	Hepatosplenomegaly (HSM)
Neurological	Small head circumference	Microcephaly
		Encephalitis
		Mental retardation