Gynecologic and Pregnancy Related Infections Part 4 Flashcards
What are the TORCH infections?
- Toxoplasmosis
- Other –> syphilis, VZV, parvovirus B19
- Rubella
- CMV
- HSV/HIV
What is toxoplasmosis?
- Protozoan parasite
- Found in cat feces and raw meat
What causes the congenital infection in toxoplasmosis?
- Tachyzoites which spread transplacentally
What are the congenital effects of toxoplasmosis?
- Chorioretinitis
- Intracranial calcifications
- Hydrocephalus
- Stillbirth
How is toxoplasmosis diagnosed?
- Serology with IgG and IgM
What is seen in early congenital syphilis?
- Mucous membrane involvement –> rhinitis
- Rash on soles and palms
- Condyloma lata
- Hepatomegaly with jaundice
What is seen in late congenital syphilis?
- Neurosyphilis –> sensorineural hearing loss
- Gumma formation
- Bone and teeth involvement
- Interstitial keratitis
What bone and teeth malformations are seen in late congenital syphilis?
- Saber shins
- Saddle nose
- Frontal bossing
- Hutchinson’s teeth (central tooth notching)
What is the treatment for syphilis?
- Penicillin
What is primary varicella?
- Chicken pox
- Fever, malaise, diffuse vesicular rash
- Varicella pneumonia
What is reactivation of herpes zoster?
- Latent in sensory ganglia
- Reactivation in peripheral nerves
- Vesicles along dermatomes
What is congenital varicella syndrome?
- Limb hypoplasia
- Cicatricial skin lesions
- Neurological and eye abnormalities
What is neonatal varicella?
- Peripartum maternal VZV
- Exposed infant –> treat with immune globulin
- Severe/disseminated –> treat with acyclovir
What does parvovirus B19 look like in a child?
- Slapped cheeks
What complications arise from parvovirus B19?
- Fetal loss
- Fetal anemia
- Hydrops –> high risk of fetal death
What is seen in congenital rubella syndrome?
- Sensorineural hearing loss
- Heart disease –> PDA
- Cataracts and glaucoma
- Blueberry muffin baby
What does congenital CMV look like?
- Sensorineural hearing loss
- Intellectual disability
- Chorioretinitis
When is GBS screened for?
- 35-37 weeks with a swab
What is the risk to a newborn with GBS?
- Sepsis
- Meningitis
- Pneumonia
What is the virulence in GBS?
- Anti-phagocytic carbohydrate capsule
What is the treatment of GBS intrapartum?
- Penicillin G or Ampicillin
What is seen in post partum endometritis?
- Fever
- Uterine tenderness
- Tachycardia
- Midline lower abdominal pain
What are some risk factors for post partum endometritisi?
- Colonization with GBS
- C section delivery
What is the treatment for endometritis?
- Gentamicin PLUS clindamycin
OR - Ampicillin/sulbactam
What causes an infection of actinomyces?
- IUD
What is actinomyces?
- Anaerobic, filamentous gram pos bacteria
What does actinomyces infection look like?
- Ascends from the uterus to give PID like symptoms
What is the treatment for MSSA lactational mastitis?
- Amoxicillin/clavulanate
What is the treatment for MRSA lactational mastitis?
- Bactrim
What does clavulate do?
- Inhibits penicillinases
What is the spectrum of Bactrim?
- Many gram neg and gram pos
- NO anaerobic coverage with small protozoan coverage
What does Bactrim do?
- Displaces bilirubin from its binding site in plasma causing kernicterus in neonates
