Newborn Infections

Question 1

HSV local infection typically will present in the newborn at:

Answer 1

1-2 weeks of life and often present at areas of trauma

Question 2

CNS complications of HSV infection:

Answer 2

Seizures and encephalitis- occurs most commonly 2-4 weeks of life

Question 3

Disseminated HSV infection typically presents:

Answer 3

During first 2 weeks of life

Question 4

HSV infection diagnosis:

Answer 4

Vesicle scrapings for rapid diagnostic tests.
Cutaneous and mucous cultures are preferably obtained 24-48 hours after delivery to differentiate colonization from true infection but should be done immediately in symptomatic infants.

Question 5

HSV treatment:

Answer 5

Skin/mucus membrane involvement: acyclovir IV 20mg/kg/dose QID for 14 days.
CNS involvement- same just 21 days

Question 6

Chlamydia infection of the newborn happens:

Answer 6

At time of delivery via inoculation of the infants eyes or respiratory tract.

Question 7

TX for chlamydial infection:

Answer 7

Erythromycin 50mg/kg/day QID for 10-14 days

-risk of pyloric stenosis

Question 8

When do chlamydial eye and respiratory infections typically occur?

Answer 8

Eye- 5 days post-delivery

Respiratory- up to 19 weeks post delivery

Question 9

When do gonorrheal infections present:

Answer 9

2-5 days post delivery

Question 10

Gonorrheal treatment:

Answer 10

1 dose ceftriaxone 125 mg IV/IM

Question 11

Gonorrheal ophthalmia is also called:

Answer 11

Ophthalmia neonatorum and discharge and swelling is more significant than with chlamydial infection.

Question 12

Types of group B infection:

Answer 12

EArly onset- first 24 hours of life

Late onset- during second week of life

Question 13

Infants with early-onset disease and are symptomatic at birth indicate-

Answer 13

An intrauterine infection

Question 14

Risk factors for GBS infection:

Answer 14

Infants less than 37 weeks gestation 
ROM longer than 18 hours 
Maternal fever during labor 
Previous delivery of a sibling with invasive GBS
Maternal chorioamnionitis

Question 15

Required diagnostic tests for GBS:

Answer 15

CSF culture

Blood culture

Question 16

GBS management:

Answer 16

Ampicillin IV

Gentamicin IV

Question 17

Prevention of GBS:

Answer 17

Screening of all pregnant women at 35-37 weeks
IV penicillin or ampicillin given at onset of labor and repeated every 4 hours until baby is born except with c-section: given before onset of labor

Question 18

Laboring women with unknown GBS status should be given antibiotics if:

Answer 18

Labor starts prior to 37 weeks gestation
Prolonged ROM greater than 18 hours
Fever during labor

Question 19

Antibiotics given to mother in labor only prevent what type of GBS infection?

Answer 19

Early-onset

Question 20

Fetal alcohol syndrome effects on the fetus:

Answer 20

IUGR
Increased rate of malformation
Chronic fetal hypoxia

Question 21

Common characteristics of infants with Down syndrome:

Answer 21

Hypotonia
Hyperlaxity 
Oblique palpebral fissures
Protruding tongue 
Flat nasal bridge 
Small ears 
Brush field spots on the iris 
Short, wide hands 
Simian creases
Growth retardation 
Wide gap between first and second toes 
Mental retardatiob

Question 22

Down syndrome screening:

Answer 22

1st trimester- beta-HCG and US for NT test

2nd trimester- 15-19 weeks- quad screen- AFP, estriol, HCG, and inhibin-Alpha

Question 23

Lab values for Down syndrome screening:

Answer 23

AFP- decreased
uE3- decreased
HCG- elevated
Dia- elevated

Question 24

Children with Down syndrome should get what screenings?

Answer 24

Cardiac echo at diagnosis at prn
Screen for MV prolapse one adolescents
Hearing at birth and at 6 month
Eye screenings at 4m, 12m, and 24 m then q2years
Thyroid as newborn, 6 months, 12 months, annually
Cervical spine at 3-5 years