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congenital infections Flashcards

1
Q

how can we make a prenatal diagnosis of congenital infections ?

A

using amniocentesis

percutaneous umbilical cord sampling

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2
Q

when during the pregnancy is rubella most commonly seenn ?

A

first trimesteric infection n

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3
Q

what is the triad for congenital rubella ?

A

congenital heart disease ( PDA, PS)
cataract
deafness

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4
Q

how would a mother present with a rubella infection ?

A

at early pregnancy, 11 weeks or so , she presents with fever, rash and lymph node affection , with no findings on ultrasound

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5
Q

what is the pathogenesis of rubella infection /

A

virus induced tissue damage

virus induced retardation of cell division

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6
Q

how does the timing of infection affect the extent of damage in rubella ?

A

first trimester - severely damaged infant
11-20 weeks - risk of deafness only
after 20 weeks - risk of fetal damage is minimal

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7
Q

how is a diagnosis of rubella made ?

A 
mother - seroconversion on screening
fetus - amniocentesis, CVS , PCR
infant - urinary PCR 
Blood or CSF culture 
Rubella specific IgM or persistently rising IgG
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8
Q

how are women with rubella treated ?

A

only given symptomatic treatment

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9
Q

how can rubella be prevented ?

A

MMR vaccine

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10
Q

what cells are targeted by the parvovirus B19 ?

A

erythroblastic red cell precursors

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11
Q

what is a common name for parvovirus B19 infection ?

A

slapped cheek disease

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12
Q

what is the mode of transmission of parvovirus ?

A

vertical transmission

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13
Q

how is a mother infected by parvovirus ?

A

through infected blood

respiratory secretions

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14
Q

how can parvovirus be diagnosed by lab investigations ?

A

findings will show
anemia
leukocytosis
reticulocytopenia

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15
Q

what is specifically found in fetal livers in parvovirus infectionn ?

A

inclusion bodies

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16
Q

how can i tell that the baby is anemic ?

A

severely edematous
has hepatosplenomegaly
( hydrops fetalis / buddha sign )

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17
Q

when is the risk of fetal loss the highest with parvovirus infections ?

A

in 2nd trimester

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18
Q

how can a diagnosis of parvo virus be made from the mother and the baby ?

A

B19 IgM
B19 IgG seroconversion
in the fetus :
B19 NAT , Hb

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19
Q

how can parvovirus infections be managed ?

A

no antiviral
regular screening
in cases of severe anemia intrauterine fetal blood transfusion can be done

20
Q

what is the most common congenital infection ?

A

cytomegalovirus

21
Q

what can CMV infection be confused with ?

22
Q

what is the C/P of CMV in mnothers ?

A

may be asymptomatic
or
glandular fever like illness

23
Q

how can CMV transmission occur ?

A

vertical transmission
during birth
through breast feeding

24
Q

how does the risk of the fetus change in CMV ?

A
  1. primary infection - risk of fetal damage throughout pregnancy
  2. secondary infection - risk of damage is low
25
what is the presentation in CID ?
mental retardation spastic diplegia sensorineural hearing loss epilepsy
26
what do the intracranial calcifications associated with CMV look like ?
railway calcifications
27
how can a diagnosis of CMV in the fetus be made ?
quantification of CMV but fetus must be at least 21 weeks
28
what is the management for CMV ?
no specific anti-viral | however ganciclovir can reduce the sensorineural hearing loss
29
what are the maternal consequences of varicella ?
varicella pneumonitis
30
what does fetal varicella syndrome look like ?
skin scarring in dermatomal distribution eye defects limb hypoplasia neurological abnormalities
31
what are the fetal consequences if varicalla was acquired in : 1st and 2nd trimester 2nd and 3rd trimester around delivery ?
1st and 2nd trimester - congenital varicella syndrome 2nd and 3rd - zoster in infancy around delivery - neonatal varicella
32
what effect does maternal shingles have on the fetus ?
no risk unless the mother is immunosuppressed or the shingles is disseminated
33
what is the management and prevention for VZV ?
1.contact with shingles/chicken pox : VZIG for susceptible within 10 days 2.Maternal chickenpox at birth: VZIG for neonate
34
what is the treatment for chickenpox ?
acyclovir for shingles | zoster immunoglobulins for child
35
in neonatal HSV which types is relativley more common ?
HSV-2
36
what is the presentationn nof neonatal HSV ?
localized infection - eye, mouth and skin | widespread with severe CNS sequelae
37
what is toxoplasmosis infection ?
protozoal infection from cat faeces or undercooked meat
38
what is the infectious stage of toxoplasmosis ?
tachyzoite
39
what is the classical triad of congenital toxoplasmosis ?
intracranial calcifications hydrocephalus acute fundal chorioretinitis
40
what do the intracranial calcifications in CMV vs Toxoplasmosis look like ?
CMV - railway or peri-ventricular | Toxoplasmosis - dotted
41
what is the management of toxoplasmosis ?
``` termination treatment : sulphadiazine pyrimethamine folic acid alternating with spiramycin ```
42
what is the treatment of toxoplasmosis for the neonate ?
sulphadiazine pyrimethamine folic acid and must be continued for one year to avoid chorioretinitis
43
if a woman has toxoplasmosis and wants to get pregnant what should be advised ?
to delay pregnancy until her serology is clear
44
what are the manifestations of syphillus ?
interstitial keratitis hutchinson's teeth clutton's joint
45
how can screening for syphilis be done ?
through EIA , followed by a confirmatory test of TPPA and follow up can be achieved by RPR
46
what is the management of an neonate infected with syphilis ?
iv or IM penicillin for 10 days
47
what is the clinical neonatal presentation of CMV ?
``` petechia jaundice seizures hepatosplenomegaly small for gestational age ```

WH (68 decks)

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