Congenital Infections Flashcards
Name the TORCH infections.
Toxoplasmosis, Other (syphilis, parvovirus B19, VZV, enteroviruses, Zika, listeria), Rubella, CMV, Herpes simplex virus.
What are the typical findings in symptomatic congenital toxoplasmosis?
Microcephaly, hydrocephalus, hepatosplenomegaly, jaundice, maculopapular rash or thrombocytopenic purpura (blueberry muffin rash), chorioretinitis, and widespread parenchymal cerebral calcifications.
How might one differentiate between cerebral calcifications caused by congenital toxoplasmosis compared to those caused by congenital CMV?
If calcifications “CircuMVent” the ventricles (are periventricular), the cause is most always CMV and not toxoplasmosis, which usually causes more diffuse cerebral calcifications.
What is the recommended treatment regimen for prenatally diagnosed congenital toxoplasmosis?
If the mother is diagnosed between 7-34 weeks’ gestation and fetal infection is excluded, the mother should take spiramycin 1g q8h until term. If the mother is diagnosed after 34 weeks’ gestation or fetal infection is confirmed, the mother should instead take pyrimethamine, sulfadiazine, and leucovorin until birth. The affected infant should receive 12 months of therapy after birth as well.
Describe the relationship between the rates of infection and the severity of disease for infants diagnosed with congenital toxoplasmosis in relationship to the stage of pregnancy in which the infection was acquired.
The fetus is more likely to have a congenital infection if the disease is acquired later in pregnancy; however, in contrast, the severity of clinical disease in the infant is inversely related to gestational age, so those infected later in pregnancy are usually asymptomatic.
What steps should be taken by pregnant women to avoid contracting toxoplasmosis?
Avoid eating rare or undercooked meat, avoid handling cat litter, and if gardening, wear gloves and wash hands thoroughly since cats often defecate in garden soil areas.
What are some of the common findings in congenital syphilis?
Hepatomegaly, jaundice, nasal discharge (“snuffles”), rash, generalized lymphadenopathy, and skeletal abnormalities (e.g. mataphyseal lucent bands, localized demineralization, diaphyseal periostitis, metaphyseal serration).
What is the only effective therapy for patients with congenital syphilis?
Parenteral Penicillin G
What are the rare complications associated with contracting Parvovirus B19 during pregnancy?
Infection between weeks 10-24 of pregnancy can result in a 7-10% risk of the fetus developing severe anemia, heart failure, hydrops fetalis, and death.
