Neonatal Infection Flashcards
Features of CMV infection
IUGR SNHL ** LOW PLATELETS Microcephaly periventricular calcification Chorioretinitis hSM Purpuric rash anemia
Features of congenital Toxo
Cerebral calcifucation
hydrocephalus
retinopathy
What are early manifestations of congenital syphilis
early manifestations -
5 factors required for a screening program
sensitivity/specificity of test acceptability and feasibility of diagnostic test benefit of early detection disadvantages of testing prevalence of disease
What is the risk of transmission of HIV from BF
9% / yr
Can HIV mom’s deliver vaginally?
yes, if Viral load
what are late manifestations of congenital syphilis?
pseudoparalysis - short maxilla frontal bossing high arched palate Hutchinson TRIAD - interstitial keratitis, Hutchinson incisors, and eighth nerve deafness! saddle nose mulberry molars higoumanakia sign -UL enlargement of the SCM portion of the clavicle saber shin
What are findings consistent with congenital rubella
Rubber Ducky, I’m so blue!
Rubber: Rubella
Ducky: Patent Ductus Arteriosus, VSD and pulmonary artery stenosis.
I’m: Eyes (cataracts, retinopathy, micropthalmia, glaucoma).
Blue: “Blueberry Muffin” rash (extramedullary hematopoesis in skin +purpura)
· Also, deafness, growth retardation
who should be treated for congenital CMV?
Confirmed congenital CMV who have evidence of brain involvement, SNHL, chorioretinitis
how do you treat CMV in a TORCH
Intravenous ganciclovir 6 mg/kg b.i.d for 6 weeks
Close monitoring of neutrophil count
Consider interruption of therapy if ANC
UTD congenital CMV criteria for treatment
- Viral sepsis-like syndrome caused by CMV
- Pneumonitis or severe and refractory thrombocytopenia
- Sight-threatening retinitis
- Colitis
- Primary immune disorder (ie, SCID) and CMV infection
**Sensorineural hearing loss
●Microcephaly and other central nervous system involvement
●Symptomatic congenital CMV disease, with or without hearing loss or obvious CNS involvement at birth
what is the treatment of congenital toxo?
Pyrimethamine + sulfadiazine + leucovorin x12 months
Frequent monitoring of neutrophil count
Steroids for eye disease and possibly hydrocephalus
VP shunt for hydrocephalus
congenital varicella
cicatricial scars limp hypoplasia Microphthalmia, enophthalmia, cataract, chorioretinitis IUGR microcephaly
what are the risks of fetal losses post Parvo infection
10% risk of fetal loss if infection prior to 20 weeks gestation
1% risk of hydrops/death if infection after 20 weeks gestation
