Congenital Infections Flashcards
What are the TORCHES infections?
Toxoplasmosis Rubella CMV Herpes/Hepatitis Syphilis
What is the common presentation for most TORCHES infections?
SGA or IUGR Thrombocytopenia Hepatosplenomegaly Jaundice Microcephaly
How can Toxoplasma gondii be acquired?
Cat Feces
Undercooked meat
Undercooked eggs
Unpasteurized milk
What is the most common clinical finding in Congenital Toxoplasmosis?
Chorioretinitis
Intracranial Calcification
Hydocephalus
What is chorioretinitis?
Inflammationof the posterior portion of the uvea tract and retina
Manifest later as Blurry vision, retinal detachment, glaucoma
Where are intracranial Calcifications?
Caudate nucleus
Choroid Plexus
Meninges
Subpendyma
PeriVentricular most classic for cmV
How is Toxoplasmosis diagnosed?
Serum IgM titers or persistent IgG Optho exam Neuro Exam Head CT LP (Toxo PCR)
What are the most common outcomes in Toxoplasmosis Infections?
Mental Retardation
Seizures
How is rubella transmitted?
Vertical Transmission or respiratory droplets
German Measles
What are the most common presentations of Congenital Rubella Syndrome?
Patent Ductus Arteriosus
Deafness
Cataracts
How is Rubella Treated?
Reverse Transcriptase PCR
Serum IgM
Rise in IgG titer over 2-3 weeks
Culture
What is the most common congenital infection in developed countries?
Cytomegalovirus
How is CMV transmitted?
Infected secretions
Vertically
Transfusion
Infection with CMV in which semester leads to the worst sequelae?
1st trimester.
What are the most common findings in CMV?
Petechia/Ecchymosis
Jaundice at birth or within a few hours
Hepatosplenomegaly
What causes the charicteristic Bluberry muffin rash in CMV?
Erythropoesis occurring in the skin, not the BM.
Where are Intracranial Clcifications seen in cmV?
PeriVentricular
How is CMV diagnosed?
Urine CMV culture
Serum IgM titers
Head CT
What is the Treatment for CMV?
Gancyclovir possibly
What are the non-congenital manifestations of HSV?
Genital Herpes Gingivostomatitis Conjunctivitis Encephalitis Eczema Herpeticum
What are the physical Findings in HSV?
SEM (Skin, Eye, mouth) Irritability Lethargy poor feeding tremulousness seizures
How is HSV Diagnosed?
Culture
CBC, LFT
PCR
How is Congenital HSV transmitted?
Ask preggo women about history of herpes and active lesions
C-Section if they have active lesions
Cultures on newborns
Tx with Acyclovir
What is the Tx for Congenital Syphilis?
Penicillin?
