Upon arrival at Children's Hospital, the child had a heart rate of 156/min, blood pressure of 86/63 mmHg, and a temperature of 36.2 degrees C. Breath sounds were equal bilaterally. The fundi were not well visualized. Neurologic examination at the outside hospital prior to intubation revealed generalized hypertonia with brisk deep tendon reflexes and spontaneous movement in all extremities. A Moro reflex was present. No focal neurologic weaknesses were noted. Oozing from the circumcision site was present. Bruising was noted over the extremities. Organomegaly was not present.