Neonatal and childhood infections

Question 1

Infections screened during pregnancy

Answer 1

o Hep B
o HIV
o Rubella status (NOT THE INFECTION ITSELF)
o Syphilis

Question 2

Symptoms of congenital Toxoplasmosis

Answer 2

 May be asymptomatic (60%) at birth but may still go on to have long-term sequelae such as:
• Deafness Low IQ Microcephaly

 40% of babies are symptomatic at birth (4 C’s)
• Choroidoretinitis Microcephaly/hydrocephalus
• Intracranial calcifications Seizures / convulsions
• Hepatosplenomegaly/jaundice

Question 3

Congenital rubella syndrome triad

Answer 3

Cataracts

Congenital heart disease (PDA; ASD/VSD) Deafness/SNHL

Question 4

Mechanism of rubella syndrome

Answer 4

Mitotic arrest of cells, angiopathy, growth inhibitor effect

Question 5

Herpes simplex virus

Answer 5

Blistering rash

o It can cause disseminated infection with liver dysfunction and meningoencephalitis

Question 6

Symptoms of congenital chlamydia

Answer 6

o Causes neonatal conjunctivitis or pneumonia (RARE)

Question 7

Why are premature neonatal at greater risk of infection

Answer 7

 Less maternal IgG
 NICU care
 Exposure to micro-organisms, colonisation and infection

Question 8

GBS morphology and symptoms

Answer 8

o Gram +ve coccus, Catalase -ve
o Bacteraemia
Meningitis
o Disseminated infection (i.e. joint infection)

Question 9

E coli morphology and symptoms

Answer 9

o Gram -ve rod
o Bacteraemia
Meningitis
o UTI

Question 10

Listeria morphology and symptoms

Answer 10

o Gram +ve rod

o Sepsis in both the mother and baby

Question 11

Cause of early onset neonatal infections (within 48 hours)

Answer 11

GBS, E coli, Listeria

Question 12

Cause of late onset neonatal infection

Answer 12

• Coagulase-negative Staphylococci (CoNS) GBS
• Escherichia coli
Listeria monocytogenes
• Staphylococcus aureus Enterococcus sp.
• Candida species

Question 13

CSF diagnosis in meningitis

Answer 13

Bacteria- -turbid, high protein >1, low glucose <2.2, polymorph leucocytes

Viral- clear, low protein <1, normal glucose, monocytes

TB- fibrin web, lower glucose 1.6-2.5, monocytes

Question 14

Meningitis Main cause and when vaccine is given

Answer 14

Neisseria meningitidis

 Given: 2m, 4m and 12m

Question 15

Which strain of meningitis causes the most mortality and when is the vaccine given

Answer 15

o Streptococcus pneumoniae

Given: 12w, 12m

Question 16

Morphology of Haemophilus influenzae and age when it causes meningitis

Answer 16

Gram-negative rod, grows glossy colonies on blood agar

3months to 5 years

Question 17

Antibiotics for streptococcus pneumonia

Answer 17

 Sensitive to amoxicillin or penicillin

Question 18

Mycoplasma pneumoniae features

Answer 18

• Tends to affect older children (> 4 years)

	Extrapulmonary Manifestations
•	Haemolysis 
o	IgM antibodies to the I antigen on erythrocytes 
o	Cold agglutinins in 60% 
•	Neurological
o	Encephalitis

Question 19

Main organisms causing UTI

Answer 19

 Escherichia coli – MAIN ORGANISM
 Other coliforms (Proteus, Klebsiella, Enterococcus sp.)
 Coagulase-negative Staphylococcus (Staphylococcus saprophyticus)