Exxcellence pearls: Parvo, CMV and Toxo Flashcards
What type of virus is parvovirus?
What disease does this cause and how does it present?
Single-stranded DNA virus
Erythema infectiosum or fifth disease presents with the flu-like symptoms such as low-grade fever, malaise, arthralgia and “slapped cheek” rash
How is maternal parvovirus infection diagnosed?
Positive IgM or four-fold rise in IgG
What type of virus is cytomegalovirus?
How is this most commonly transmitted?
Double-stranded DNA virus.
Fecal oral contact particularly via daycare settings.
How do people with CMV infection present?
Malaise, fever, lymphadenopathy, similar to mono
What is the fetal sequelae of congenital parvovirus?
How is this monitored and treated?
What is long-term prognosis?
Profound anemia and hydrops likely due to aplastic crisis, hepatitis, and myocarditis.
Weekly MCA Dopplers for 10 to 12 weeks with intrauterine transfusion if hydrops develops.
Very good prognosis without neurologic sequelae.
What percentage of primary maternal parvovirus infections result in vertical transmission?
When is fetal infection most common?
When are the sequelae the greatest?
30-50%
Third trimester.
First trimester.
What is the most reliable way of diagnosing congenital CMV?
PCR of amniotic fluid
What are the ultrasound findings of congenital CMV infection? Neonatal sequelae?
What percent of infected newborns will have signs of congenital infection?
What percent will have a long-term symptoms?
Fetal growth restriction, intracranial calcifications, microcephaly, chorioretinitis. Vision and hearing loss, jaundice, seizures.
10%
90%
How do most people present with toxoplasmosis?
Asymptomatic
What type of organism is the cause of toxoplasmosis?
How is it transmitted?
Toxoplasma gondii is a protozoan.
Transmitted through uncooked meat, contaminated soil, and cat feces
During which trimester is congenital toxoplasma infection most likely to occur?
What are the ultrasound findings of congenital toxoplasmosis?
Third trimester
Periventricular calcifications, ventriculomegaly, placentomegaly
What medications are used to treat congenital toxoplasmosis?
Spiramycin to prevent infection.
Pyrimethamine and sulfadiazine after the first trimester for diagnosed fetal infection along with folinic acid to prevent bone marrow suppression from pyrimethamine.
