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Unit 6: Micro > Congenital/Perinatal Infections > Flashcards

Congenital/Perinatal Infections Flashcards

1
Q

What does TORCH stand for?

A
  • Toxoplasmosis
  • Other
  • Rubella
  • CMV
  • HSV
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2
Q

What are the “Other” pathogens?

A
  • Syphilis
  • Hepatitis B
  • Varicella-zoster
  • Parvovirus B19
  • HIV
  • HTLV-1
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3
Q

What determines the severity of congenital infections?

A

The earlier the mother is infected the greater the risk to the fetus; Acute maternal infection is worse than reactivation of the fetus (higher infectious dose causes more harm)

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4
Q

Routes of transmission of perinatal infections

A
  • Exchange of maternal/fetal blood
  • Fetal monitors that break skin
  • Vaginal/skin flora
  • Breastmilk
  • Relatives and visitors
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5
Q

Usual route of congenital infection?

A

Maternal viremia

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6
Q

Serious manifestations of congenital infection?

A
  • Microcephaly
  • Hearing loss
  • Blindness
  • Rash
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7
Q

Strategies used to identify risk/existence of congenital/neonatal infection?

A
  • Recognize maternal exposure
  • Detect IgM or rising IgG in maternal serum
  • Sample body fluids
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8
Q

What is the method for definitive Dx of congenital infections?

A

Isolate pathogen from infant using urine, saliva, CSF, nasopharyngeal swabs

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9
Q

What is CMV?

A
  • Herpes virus
  • Ubiquitous
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10
Q

Histo findings of a person w/ CMV?

A

Giant cells form giving “owl eye” appearance

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11
Q

General Px in people who get CMV infection?

A

Generally asymptomatic mononucleosis with essentially no sequelae

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12
Q

Where does CMV likely lie latent?

A

Bone marrow

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13
Q

Risk factors for congenital CMV?

A
  • Mother has no prior infection
  • Pregnancy at young age
  • First pregnancy
  • New sex partner during pregnancy
  • Frequent contact w/ babies and toddlers (daycare)
  • Mother’s illness may be subclinical
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14
Q

At what point in the pregnancy is Px for congenital CMV the worst?

A

During early pregnancy

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15
Q

Describe transmission and pathogenesis of CMV

A
  1. CMV passes thru maternal blood thru placenta (NOTE: Primary infection much higher viral load than reactivation)
  2. Virus spreads thru fetus
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16
Q

What is the most common congenital abnormality caused by CMV?

A

Hearing loss

17
Q

Tx and Prevention for CMV?

A
  • Tx: Ganciclovir
  • Prevention: NONE
18
Q

Which HSV has a worse outcome?

A

HSV2

19
Q

What type of HSV infection is worse? Primary or reactivation?

A

Primary

20
Q

What is worse? Visible lesions on the mother with HSV or subclinical reactivaiton?

A

Visible lesions

21
Q

What type of HSV infection of the child would be worse? Perinatal or intrauterine?

A

Intrauterine

22
Q

What is the worst manifestation of HSV in a neonate?

A

Dissemination > Encephalaitis > skin lesions

23
Q

Most frequent scenario in which neonatal HSV occurs?

A

Mother has recurrence of HSV2 at the time of birth, and neonate acquires virus at full term

24
Q

Typical Px for neonatal HSV?

A

Good outcome

25
Q

Severe scenario of HSV infection?

A

Mother has primary HSV2 infection during pregnancy and fetus is born w/ disseminated virus, severe mental impairment, death

26
Q

Tx and Px of HSV at birth?

A

Acyclovir (well-tolerated)

C-section, antiviral prophylaxis

27
Q

Scenario in which neonatal varicella syndrome occurs?

A

Mother contracts primary varicella

28
Q

Prevention for congenital varicella?

A

Vaccination of all seronegative women and advise seronegative women to avoid children w/ chickenpox or anyone w/ shingles

29
Q

What is the pathogenesis of congenital rubella?

A

Virus spreads from blood, to placenta, to fetus

30
Q

Classic abnormality of congenital rubella?

A

Hearing loss and congenital heart defects (patent ductus arteriosus)

31
Q

What group is at serious risk of parvovirus B19 death?

A

Seronegative pregnant women

32
Q

Tx and prevention for Parvovirus B19?

A

NONE!

33
Q

What are the two retroviruses that are of concern for congenital spread?

A

Human T-lymphotropic virus type I and HIV types 1 and 2

34
Q

Strategy to prevent transmission of HIV to baby?

A

Antiviral medications (zidovudine) before during and after pregnancy

Maximally suppress viral load, minimize the risk of developing resistant virus, reduce the risk of perinatal transmission

35
Q

What is the Tx strategy for HBV+ mother and baby? HBV- mom and baby?

A
  • HBV+ - counsel mother to avoid high risk behaviors and give the child HBIg at birh and vaccine
  • HBV- - treat mother with HBV vaccine during pregnancy

Unit 6: Micro (13 decks)

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