Which of the following may indicate the presence of congenital infections in a newborn?

The presence of congenital infections in a newborn can manifest in various ways, and all the listed conditions—hepatomegaly, splenomegaly, and combined hepatosplenomegaly—can indeed indicate such infections. Congenital infections, such as cytomegalovirus (CMV), toxoplasmosis, and syphilis, can cause abnormalities in the liver and spleen, resulting in hepatomegaly (enlarged liver) and splenomegaly (enlarged spleen).

When both organs are enlarged, as in combined hepatosplenomegaly, it further supports the potential diagnosis of a congenital infection since it's less common for both the liver and spleen to be affected by etiologies unrelated to infectious processes. The presence of these conditions in a newborn often leads clinicians to investigate further for congenital infections that can be critical for the infant’s ongoing care and management. Therefore, recognizing any of these signs can be an important part of assessing a newborn for congenital infections.