congenital infections (9) Flashcards
when is a fetus at the highest risk from toxins, mutagens, infections
1st trimester
what is worse for the fetus, primary or reactivation infection
primary infection (higher infectious dose)
how do you make a definitive diagnosis of a fetal infectious disease
isolate pathogen from the INFANT
what fetal infection is the highest in the US
CMV
what does the other stand for in torch (6)
syphilis hepB VZV B19 HIV HTLV1
how do most infants with congenital toxoplasmosis present at birth
asymptomatic
what is the classic triad of congenital toxoplasmosis
- chorioretinitis
- hydrocephalus
- intracranial calcifications
how do you treat congenital toxoplasmosis
Pyrimethamine (Daraprim) + Sulfadiazine + Folinic acid (Leucovorin)
treat for 1 year
what is the most common late finding of congenital toxoplasmosis infection
chorioretinitis (which can result in vision loss)
when do the symptoms of congenital syphilis usually present
by 3 months
usually by 5 weeks
what are some signs of congenital syphilis
large puffy white placenta hepatomegaly rhinitis (snuffles) rash lymphadenopathy
how do you treat syphilis
treat mother and infant with penicillin
what is the most common symptom seen in congenital rubuella?
what are some other symptoms?
most common-hearing loss
congenital heart defects (PDA)
ophthalmic problems
IUGR
neuro problems
most CMV congenitally infected infants are asymptomatic at birth, 10% have symptoms, what are some?
– small size, hepatosplenomegaly, rash, jaundice, chorioretinitis, neurologic
involvement, including microcephaly, seizures, abnormal neurologic examination,
and feeding difficulties
what are 2 drugs that can be used for congenital CMV infection
– Ganciclovir IV
– Valganciclovir PO
type 1 or type 2, what herpes is worse for babies
type 2
whats worse, intrauterine infection of perinatal infection with HSV2
intrauterine infection
whats worse for the infant, a disseminated infection or encephalitis
disseminated infection
what is the most severe situation for a infant getting a herpes infection? what are the outcomes for this presentation
mother has primary HSV2 infection during prego and fetus is born with disseminated disease
severe mental impairment, death
how can you treat an infant with congenital herpes
IV acyclovir
congenital varicella syndrome is very rare, but how can we prevent it?
vaccination of all seronegative woman at child bearing age
acyclovir for mother
what are the other names for paravirus B19
5th disease
erythema infectiosum
so paravirus is the 5th disease, what are the first 4?
1st varicella
2nd rubella
3rd roseola
4th measles
idk if this is imp to know
B19 is a biphasic disease, explain this to me
-Febrile illness without rash precedes
-“slapped cheek” rash on face
- Erythematous maculopapular rash, arthralgia,
arthritis
what is the treatment and prevention for B19
none!
how can you prevent & treat an infant that was exposed to hep B
- Vaccinate all neonates
- Add HBIG immune globulin at birth if mother is HBV +
if a woman with HIV isn’t already on a set treatment regime, what antiretrovial treatment should you give them?
zidovudine regime antenatal, intrapartum and neonatal
what is the agent in group B strep
streptoccus agalactiae
what is the bacteriology of strep agalactiae
gram stain
shape
gram positive
shape: diplococcus
what are some risk factors for early onset GBS disease
- Previous baby with GBS disease
- GBS in urine
- Fever during labor
- Heavy maternal colonization
- Delivery before 37 weeks of gestation
- Premature or prolonged rupture of membranes
what are the time frames for the GBS infections
early onset (in 1st week) late onset (1 week-3 mo) late, late onset (greater than 3 months)
what symptom predominates in the early onset GBS
respiatory
what symptom predominates in the late onset of GBS infection
CNS symptoms
a mother is GBS positive, what do you do?
- IAP: Intrapartum Antibiotic Prophylaxis
- Penicillin G, IV
what congenital infections have vaccines (3)
rubella
varicella
hepB
