Congenital Flashcards
Late sequelae- match
Hearing loss, minimal to severe brain dysfunction ( motor, learning, language, behavioural disorders)
Hearing, brain dysfunction, autism, diabetes, thyroid, precocious puberty, brain degeneration
Chorioretinitis, brain dysfunction, hearing loss, precocious puberty
Recurrent eye and skin infection, brain dysfunction
Subclinical hepatitis, fulminant hepatitis
CMV
Rubella
Toxoplasmosis
HSV
Hep B
Most common symptoms in symptommatic CMV
SNHL (58%) IQ<70 (55%) Microcephaly (38%) Seizures Chorioretinitis
Which congenital infection
CHD (PDA>PAS>AS>VSD) Cataract, corneal opacities, glaucoma Microphthalmia Radiolucent brain lesions Thrombocytopenia HSM Hepatitis
Rubella
Rate of congenital HSV in primary maternal disease
Recurrent disease
30-50%
3-5%
What proportion of neonatal HSV cases will have visible skin lesions?
1/3rd
What features would make one suspect HSV in unwell neonate?
Hx of 3rd trimester lesions Skin lesions suspicious Seizures Abnormal LFTS Pleocytosis (lymphocytes) Ill, irritability, hypothermia, lethargy, vomiting
6 weeks or 6 months of ganciclovir for congenital CMV ( symptomatic)
6 months improves hearing and neuro developmental outcome
Perinatal transmission
Hep B
Hep C
90%
5%
Congenital syphilis
Early manifestations in order of most common
Hepatomegaly (32%) Skeletal abnormalities (29%) Splenomegaly (18%) LBW (16%) Pneumonia Anaemia, hydrops Skin lesions Hyperbilirubinemia Snuffles, nasal discharge (9%)
Congenital syphilis
Late manifestations >2y
Orthopedic and teeth
Peg shaped teeth
Lytic bone lesions
Pseudo paralysis
Saddle nose
Toxoplasmosis transmission
1st
2nd
3rd
Trimester
25
50
65% in3rd trimester
Congenital toxoplasmosis
Proportion symptomatic
Features
Risks if asymptommatic
10-30%
Chorioretinitis Microcephaly Seizures HSM Intracranial calcification
Chorioretinitis, hearing loss, developmental delay
Treatment for toxoplasmosis
- maternal infection only
- maternal + fetal infection (amnio PCR positive)
- infant
Spiramycin 3g/day
Doesn’t cross Placenta
Pyrimethamine plus Sulphadiazine
- supplement with folinic acid, monitor FBC
The same until 12 months of age
Neonatal herpes simplex
3 main presentations
Treatment
Outcomes
What extra blood test is useful when working up the septic neonatal
CNS
Disseminated
Skin-eyes-mouth
IV acyclovir ? 6 months
30% mortality (disseminated)
70% neurological morbidity for CNS disease
LFTs: transaminitis rare in neonatal bacterial sepsis
Group B Streptococcus
% women colonised
Transmission occurs __
RFs (6)
Early onset presentations
Late onset presentations
40%
During labour
Preterm, PROM, maternal colonisation, fever, young age, ethnicity
Early- sepsis, pneumonia, meningitis (10%)
Late (>7 days) occult bacteraemia, meningitis (30%), bone and joint
Very late (>90) - prematurity and prolonged hospitalisation
