congenital infections Flashcards
classic triad of
- Chorioretinitis
- Intracranial calcifications
- Hydrocephalus
asymptomatic at birth before showing these sx
toxoplasmosis
sulfadiazine and pyrimethamine is used to tx what
toxoplasmosis
- Rash: vesicular or bullous on face, diaper area, dark red copper spots on palms and soles
- Snuffles (thick purulent nasal discharge) and fissures in the lips
- periostitis
- many are asymptomatic at birth
- untreated even without sx can develop late manifestation after 2 years
early congenital syphillis
- Sx in newborn begin within 3-7 days - pneumonia, exanthems, aseptic meningitis, encephalitis, paralysis, hepatitis, conjunctivitis, myocarditis and pericarditis
- mom gets mild non specific sx
- no specific tx
- passed perinatally
enterovirus
what should you do in infants exposed to Hep B after they complete their vaxx series
test for HBsAg and anti-HBs
- Most children with chronic infection are asymptomatic, although liver failure is possible
- spontaneous viral clearance is possible
- antibody testing at 18 months will identify if they have the infection
Hep C
is HIV transmitted via breastfeeding?
yes
what should you if HIV status is unknown in birthing parent
rapid test in labor & delivery
test in first trimester
Prenatal and intrapartum zidovudine (AZT) does what
reduces rate of HIV transmission by 68%
what kind of delivery reduces likelihood of HIV transmission
c-section BEFORE ROM
tx for infants at low risk of HIV
start AZT w/in 1 hr and continue for 4 wks
tx for infants at high risk for HIV
3 drug regimen w/in 1 hr and give AZT for 4 wks
how many times are infants tested for HIV
4 times
w/in 24 hrs, 2-3 wks, 4-6 wks, 4-6 months
- infection during pregnancy can lead to fetal death
- half of pregnant ppl are immune to it
parovirus
- Maternal varicella within _ days before delivery to _ days after delivery often fatal to infant
- tx infants w exposure with VariZig
- separate mom and baby till moms vesicles are dried
- pumped breast milk ok if no active breast lesions
5 days before delivery to 2 days after
- IUGR
- Scarring skin lesions,dermatomal distribution
- Limb hypoplasia
- Ocular defects: chorioretinitis, cataracts
- CNS: seizures, mental retardation, microcephaly
- Mortality after birth 30% without tx
congenital varicella syndrome
- Infection during first trimester slightly higher risk
- Symptomatic and asymptomatic women equally at risk for transmitting disease to newborn
- No current vaccine or antiviral treatment
zika virus
what do you do for symptomatic women w/ exposure hx to zika virus
check blood and/or urine for Zika and dengue viruses w/in 7 days of sx
what do you do for asymptomatic women w/ ISOLATED exposure hx
no testing
what do you do for asymptomatic women w/ ONGOING exposure hx
check blood 3x in pregnancy
- Severe microcephaly
- Subcortical calcifications
- Ventriculomegaly
- Growth restriction
- Eye (macular scarring) and ear abnormalities
- Developmental delays
- Contractures of major joints
these are indicative of what infant condition
congenital zika syndrome
- v rare
- all pregnant women are screened
- infection in first 20 wks leads to structural fetal defects but not in 3rd trimester
rubella
CHD
cataracts
deafness
* IUGR
* jaundice w/ HSM
* can result in miscarriage or fetal date
these are classic presentatiions for what congenital syndrome
congenital rubela syndrome (CRS)
blueberry muffin rash that fades by 3-6 wks after birth should make you think of???
CRS
most comon congenital infection is? how is it transmitted?
CMV
transmitted via transplacental passage
leading non-genetic cause of SNHL but later onset hearing loss common
congenital CMV
- Jaundice with thrombocytopenic purpura = blueberry muffin rash
- microcephaly
- intracraial periventricular calcifications
these are classic signs of?
congenital CMV
how is CMV dx? when?
- salivary PCR w/ confirmatory urine
- first 3 wks of life
when and how is congenital CMV tx?
- must start w/in first month of life
- oral valgancyclovir for 6 months (IV ganciclovir if life threatening)
with which infection do you avoid use of scalp electrode for fetal monitoring when possible
HSV
tx for neonates w/ HSV
IV acyclovir
