On examination, his weight was 7.1 kg (75th percentile); temperature, 38.1°C; heart rate, 153/min; respiratory rate, 40/min; blood pressure, 62/47 mm Hg; and oxygen saturation, 98% on room air. He appeared mildly ill, pale, and quiet. His lips were dry, he had a 2/6 flow murmur heard best at the left sternal border, his skin was mottled, and his feet were cool. The abdomen was soft without apparent tenderness. Periumbilical erythema and induration extended a distance of 0.5 cm around the umbilicus.