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3: Paeds Y3/4 - Paediatrics [15] > [69] Congenital Herpes > Flashcards

[69] Congenital Herpes Flashcards

1
Q

What is congenital herpes?

A

A rare but serious condition caused by vertical transmission of the herpes simplex virus from mother to newborn

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2
Q

What 3 different presentations of congenital herpes are there?

A
  • Localised
  • Disseminated
  • CNS herpes
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3
Q

When do the majority of congenital herpes cases occur?

A

At birth when the baby comes into contact with the infected genital secretions in the birth canal

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4
Q

What percentage of congenital herpes cases are contracted at birth?

A

85%

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5
Q

Who most commonly pass the herpes simplex virus onto their children?

A

Mothers who have become newly exposed to the virus

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6
Q

What percentage of neonates with congenital herpes contract it in utero?

A

5%

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7
Q

What percentage of neonates with congenital herpes develop it postnatally?

A

10%

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8
Q

What are the maternal risk factors for congenital herpes?

A
  • White race
  • Young maternal age
  • Primary infection in third trimester
  • First pregnancy
  • HSV seronegative
  • Discordant partner
  • Gestation <38 weeks
  • Receptive oral sex in third trimester
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9
Q

What are the neonatal risk factors for developing congenital herpes?

A
  • Black race
  • Young maternal age
  • Discordant partner
  • Primary or non-primary first episode of infection in third trimester
  • 4 or more lifetime sexual partners
  • Lower level of education
  • Previous history of STD
  • History of pregnancy wastage
  • First viable pregnancy
  • Gestation <38 weeks
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10
Q

How does localised congenital herpes present?

A

External lesions but no internal organ involvement

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11
Q

Where are lesions likely to appear in localised congenital herpes?

A

Trauma sites e.g. from instruments used during delivery, margin of the eyes, and the nasopharynx

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12
Q

How does disseminated congenital herpes present?

A

Affects internal organs including the liver

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13
Q

What is CNS congenital herpes?

A

An infection of the brain and nervous system and can lead to encephalitis

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14
Q

How can CNS congenital herpes present?

A
  • Seizures
  • Tremors
  • Lethargy
  • Irritability
  • Poor feeding
  • Unstable temperatures
  • Bulging fontanelle
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15
Q

How can congenital herpes be rapidly diagnosed?

A

By viral culture or HSV PCR

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16
Q

Where can culture samples be taken from?

A
  • Skin vesicles
  • Nasopharynx
  • Eyes
  • Rectum
  • Blood
  • CSF
17
Q

How is congenital herpes managed in the neonate?

A

With antivirals

18
Q

If a pregnant woman has active genital herpes what should be done?

A

Delivery by caesarean

19
Q

What are the potential complications of congenital herpes?

A
  • Prematurity
  • Neurological sequelae
  • Sepsis

3: Paeds Y3/4 - Paediatrics [15] (115 decks)

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