Gynecological and Pregnancy Infections Part 4 (Staudinger) Flashcards
What are the TORCH pathogens?
T = Toxoplasmosis - parasite
O = Other (Syphilis - bacteria, VZV - DNA virus, Parvovirus B19 - DNA virus)
R = Rubella - RNA virus
C = Cytomegalovirus - DNA virus
H = Herpes Simplex virus - DNA virus/HIV - RNA retrovirus
Toxoplasmosis
caused by Toxoplasma gondii a protozoan parasite; host are cats and transmitted in their feces and through raw meat; maternal infection is asymptomatic;
congenital effects: eye and CNS - chorioretinitis, intracranial calcification and in severe cases stillbirth or neurologic deficiency
Congenital effects of toxoplasmosis
eye and CNS - chorioretinitis, intracranial calcification and in severe cases stillbirth or neurologic deficiency
Serology of toxoplasmosis
IgG and IgM antibody test; not universally done; preferred in South America
Early congenital syphilis clinical presentation
nasal mucous membrane involvement called “snuffles”; desquamating rash on palms and soles; and rash in the genital area
Late congenital syphilis clinical presentation
> 2 yrs neurosyphilis: sensorineural hearing loss (CN VIII); gamma formation; bone and teeth involvement (“saber shins” “saddle nose” “frontal bossing” teeth - “Hutchinson’s teeth” “mulberry molars”); eye involvement - interstitial keratitis
Varicella Zoster Virus (VZV)
DNA virus in herpes family; primary - chicken pox; various stages of healing; reactivation - shingles; latent in sensory ganglia (dorsal root); can cause congenital varicella syndrome
Congenital varicella syndrome
caused by Varicella Zoster Virus (VZV); will present with limb hypoplasia and cicatricial skin lesions
If mom is non-immune to VZV, when do you give vaccination?
give vaccine (live) AFTER pregnancy; not safe during pregnancy
Parvovirus B19
small DNA virus; Erythema infectious AKA Fifth disease; produces an erythematous malar rash called “slapped cheek” rash; congenital B19 causes hydrops fetalis due to targeting of red blood cells; babies are at risk of high fetal death
Rubella
German Measles; rash begins on face then moves to the trunk and extremities “head to toe spread”; red “rose spots” on soft palate; causes congenital rubella syndrome
Congenital Rubella syndrome
risk of fetal loss; sensorineural hearing loss; heart disease; cataracts; dermal skin lesions “blueberry muffin baby”
If mom is non-immune to rubella, when do you give vaccination?
give vaccine (live) AFTER pregnancy; not safe during pregnancy
What is the leading cause of nonhereditary sensorineural hearing loss (SNHL) in infants?
congenital cytomegalovirus (CMV) infection; maternal infection often asymptomatic; histology will show “owl’s eye inclusions”
Congenital herpes simplex virus infection
infant infected through contact at birth; skin mouth and eye lesions; meninoencephalitis disseminated disease; treat with acyclovir
