Congenital Infections Flashcards
The vaccines in the MMR group are all?
Live attenuated
The virus that causes German measles is in the ________ family
Togavirus
What are the members of the togavirus family?
Rubella (German measles)
Eastern Equine Encephalitis
Western Equine Encephalitis
The virus that causes German measles exhibits what characteristics?
RNA virus, Enveloped, SS + linear, Icosahedral
A pregnant lady presents in her first trimester with fever, LAD, arthralgia, and a fine rash on the forehead that spread to her neck. Everything subsided after about 3 days. She’s an immigrant from Tuvalu. What 3 things will the baby most likely have?
Cataracts
PDA/pulmonary artery stenosis
Deafness
(congenital Rubella)
A newborn presents with a continuous machine like murmur. He was born to an immigrant mother. What are the characteristics of the causative agent?
RNA, Enveloped, SS +, Icosahedral
Rubella, part of Togavirus
A newborn baby presents with cataracts and deafness. Hx is positive for Indomethacin administration at birth. What type of vaccine was lacking?
Live attenuated
Rubella
When you hear blueberry muffin baby and no cataracts, think
CMV
When you hear blueberry muffin baby and cataracts or unvaccinated, think
Rubella
The most common congenital infection in America is
CMV
A newborn presents with blueberry muffin rash, deafness, and cataracts. The primary infection acquired by mom was transmitted via?
Respiratory droplets
Rubella
Mother presents during her first trimester with LAD, pharyngitis, and she complains of being extremely tired. Monospot test is negative. The causative agent stays latent where?
in mononuclear cells (lymphocytes, macrophages)
this is CMV (heterophile - mono)
Other than congenitally, how does the #1 causative agent of congenital infections get spread?
Transfusions/transplants
Fluids (sex, urine, saliva)
Congenital CMV can have what manifestations in the infant?
Hepatosplenomegaly
Blueberry muffin rash
Anemia, thrombocytopenic purpura
Conductive hearing loss (often years later)
Periventricular intracranial Calcifications
MR, seizures
A baby presents with seizures, TTP, HSM, and many purple blotches on the face. What are the characteristics of the causative organism?
Enveloped DS DNA virus
Herpesvirus family, CMV
Congenital CMV is to conductive deafness as congenital syphilis is to
sensorineural deafness
Newborn presents with notched teeth and sensorineural deafness. What is the most serious side effect of the treatment of the causative agent?
Jarisch-Herxheimer reaction (LPS released from bug, causes hi temp, arthralgia, lo BP)
Penicillin G for Treponema pallidum (syphilis)
Chancre is to ________ as Chancroid is to ________
Treponema pallidum (syphilis)
Haemophilus ducreyi
Describe the stage of syphilis at which the mother is most likely to transmit the spirochete across the placenta.
Secondary syphilis (systemic):
- Condylomata lata
- Copper body rash (infectious!!)
- Patchy alopecia
What are the characteristics of a baby exposed to syphilis in utero?
Rhinitis (organisms in discharge)
Saber shins, Hutchinson/notched teeth
CN VIII deafness, mulberry molars, saddle nose
What are the three tests that are used for syphilis?
VDRL (screening)
FTA-ABS (confirmatory)
Darkfield microscopy (confirmatory)
The VDRL test reacts with ________ and can have false positives from?
cardiolipin
Viruses, Drugs, Rheumatic fever, Lupus/leprosy
The VDRL test is most effective during what stages of syphilis?
late primary syphilis, and secondary syphilis
Darkfield microscopy can detect organisms that are gathered from?
Chancre, copper rash, condylomata lata, or nasal discharge of neonate
If a mother has flu-like symptoms and we are thinking congenital infection, the top 3 we should immediate think are:
CMV, Toxoplasma, Listeria
The two congenital infections that can result in intracranial calcifications in the child are?
CMV
Toxoplasma gondii
A neonate presents with hydrocephalus. It is also found that there are intracranial calcifications and chorioretinitis. The mother was most likely exposed to _________
Cat poop (or undercooked meat)
Neonates with hydrocephalus, chorioretinitis, and intracranial calcifications often have mothers that present how?
Most often ASYMPTOMATIC
What is one late manifestation of congenital Toxoplasma infection in the THIRD trimester?
late-onset blindness (teens/20s)
Compare the presentation of neonates exposed to Toxoplasma during the 1st/2nd/3rd trimesters.
1st: stillbirth
2nd: classic presentation
3rd: asymptomatic @ birth, blind during teens
A stillbirth presents with hydrops fetalis. The causative agent attacks immature RBCs. What are its characteristics?
non-enveloped DNA virus, linear SS -
Parvovirus B19
What group of patients is at a high risk for Parvovirus B19 infection?
Sickle Cell anemia patients
causes APLASTIC crisis
CMV is to late onset ________ as Toxoplasma is to late onset _________
deafness
blindness
