MF Infections

Question 0

Congenital toxoplasmosis diagnosis, treatment, prophylaxis

Answer 0

Diagnosis: serology
Treatment: Pyrimethamine (DHFR inhibitor) + sulfasalazine (dihyropteroate synthetase inhibitor) give with folate
Prophylaxis: spiromycin in third trimester; avoid cats

Question 1

Congenital toxoplasmosis: transmission and symptoms

Answer 1

Transmission: transplacental
Sx: hydrocephalus, intracranial calcifications, ring-enhancing lesions on MRI, chorioretinitis

Question 2

Common congenital infections

Answer 2

ToRCHES
Toxoplasmosis, Rubella, CMV, HIV/HSV, Enterovirus, Syphilis
Also: parvovirus, varicella, listeria, Tb, malaria

Question 3

Congenital rubella: diagnosis, treatment, and prophylax

Answer 3

Diagnosis: serologic testing
Treatment: symptomatic

Prophylaxis: warn women to get pregnant > 1 month after MMR vaccine; but no evidence of harm if they haven’t waited 1 month

Question 4

Congenital HIV: diagnosis, treatment, prophylaxis

Answer 4

Diagnosis: ELISA and Western Blot
Treatment: HAART

Prophylaxis:

• if mom has VL > 1000, get a C-section
• AZT or nevirapine to mom before birth
• give infants AZT after birth
• avoid breastfeeding

Question 5

Congenital CMV transmission and symptoms

Answer 5

Transmission: transplacental
Symptoms: petechial rash w/ periventricular calcifications

Question 6

Congenital CMV: diagnosis and treatment

Answer 6

Diagnosis: urine culture, amniotic fluid PCR
Treatment: postpartum ganciclovir

Question 7

Congenital HSV: transmission and symptoms

Answer 7

Transmission: intrapartum if mom has lesions during birth
Symptoms: skin, eye, and mouth infections. Life-threatening CNS and systemic infection can occur

Question 8

Congenital HSV: diagnosis, treatment, prophylaxis

Answer 8

Diagnosis: serologic
Treatment: acyclovir when infection is found; get C-section if active lesions have been found

Question 9

Congenital HIV: transmission and symptoms

Answer 9

Transmission: in utero, at birth, in breath milk
Symptoms: failure to thrive, bacterial infections, increased incidence of upper and lower respiratory infections

Question 10

Congenital syphilis: transmission, early symptoms, late symptoms

Answer 10

Transmission: intrapartum
Early symptoms: maculopapular rash, LAD, hepatomegaly, mucopurulent rhinitis (snuffles), osteitis
Late symptoms: saber shins, saddle nose, CNV involvement, Hutchinson triad: peg-shaped central incisors, deafness, interstitial keratitis

Question 11

Congenital syphilis: diagnosis, treatment, and prophylaxis

Answer 11

Diagnosis: VDRL/RPR followed by FTA-Abs
Treatment: Penicillin
Prophylaxis: RPR+ pregnant women should get Penicillin

Question 12

Congenital rubella: transmission and symptoms

Answer 12

Transmission: transplacental in first trimester
Symptoms: purpuric “blueberry muffin” rash, cataracts, hearing loss, PDA, mental retardation