Congenital, Perinatal & Neonatal Flashcards
Beta hemolytic streptococci main vitulence factor is…..
Polysaccharide capsule
……is not recommended as diagnostic specimen for GBS colinization in pregnant females
Cervical swabs
Describe ttt of GBS colonized pregnant women
Durong pregnancy at the time of diagnosis as well as at delivery: ampicillin and aminoglycosides
All vaginal and rectal carriers: intrapartum ampicillin
List causative agents of neonatal meningitis & septicemia
GBS
Listeria monocytogenes
E.coli K1
Mention identification criteria for L.monocytogenes
Gram +ve bacilli
Chct tumbling motility at 18-22degC
Catalase +ve, oxidase/urease/indole -ve
Describe pathogenesis of L.monocytogenes
It is a facultative intracellular parasite infecting epithelial cells, macrophages & other parenchymal cells. After ingestion they enter target cells & by help of listeriolysin O escape the phagocytic vacuole to multiply in cytoplasm then attached to cytoskeleton to spread to other cells. Thus they are not exposed to humoral immunity of PMNL. Immunity is cell mediated
Describe CP of neonatal listeriosis
- Early: granulomatosus infantiseptica causes abscesses & granulomas in multiple organs leading to abortion, uterine fetal death or death after delivery
- Late: meningo-encephalitis or meningitis with sepsis within 2-3 wks
CP of neonatal syphilis
- Early: in first 2 yrs: rhinitis, skin & mucosal lesions, hepatosplenomegaly, lymphadenopathy, abnormalities of bones, teeth, cartilage
- Later: above 2 yrs, interstitial keratitis, Hutchinson’s teet, saddle nose, deafness, atrophy of optic nerve periostitis & CNS abnormalities
Describe lab diagnosis for congenital syphilis
- An abnormal physical exam consistenet with congenital syphilis
- Serum quantitative non-specific test (VDRL) serologic titer that is 4-fold higher than mother
- +ve dark field test or PCR of lesions or body fluids
Fetus is particularly susceptible to Rubella virus if infection occurs..
Before 16 wks
Mention CP of congenital rubella
LBW, congenital heart and eye defects esp cataract, deafness, nwurological abnormalities, effects on brain and ear may not be detectable till later.
Describe lab diagnosis of congenital rubella
Fetal rubella IgM in cord and infant blood, viral isolation from urine or throat, RT-PCR
Pregnancy is CI……after rubella vaccination
1 month
CMV infection is most severe on fetal CNS in….trimester of pregnancy
1st
Mention CP of CMV infection
Mental retardation, microcephaly, optic atrophy, hearing defects, hepatosplenomegaly, thrombocytopenic purpura and anemia, deafness and mental retardation but detectable later
Describe lab diagnosis of CMV
Detecting CMV-specific IgM Abs in infant blood within 3 wks of delivery, detect CMV DNA in blood or culture during this period, virus can be isolated from throat swab or urine samples
Ttt of CMV infection is…….
Gancyclovir and valgancyclovir
Compare manifestations of congenital and neonatal VZV
C, LBW, sacrring of skin, abnormally small head, neurologic and vision problems.
N, chance of death as hifh as 30% as immune system of neonate is not well-developed
Describe lab diagnosis and prevention of neonatal HIV
-PCR is mainstay, IgG Abs may be materal and persist for a year
-Transmission rates are reduced by lowering HIV load by offering antiretroviral drugs during pregnancy, C-section, avoid breastfeeding.
Parvovirus B19 infection affects the fetus the most if it occurs in…..
Describe its effect
Between 10th and 20th wks
Arrest of fetal RBCs, non-immune hydrops fetalis and fetal death from severe anemia
Mention CP of congenital HSV infection
- Cutaneous lesions of HS may develop 1 wk after delivery with generalized infection amd sever CNS involvement
- May be missed as 39% have not skin lesion
- Morbidity and mortality rates are higher with encephalitis and disseminated disease
What is lab diagnosis for HPV
Juvenile larygeal papillomas are diagnosed through larygoscopy and can be confirmed thrpigh biopsy and DNA detection
