perinatal and congenital infections Flashcards
what is the differnce in a congenital and perinatal infection?
congenital- happens whiel in the uterus
perinatal- during labor and delivery
what are the “TORCH” infections?
toxoplasmosis, Others, rubella, CMV, Herepes
Others= VZV, syphilis, Group B strep, parvo B19, HIV
who gets the worst of these infections? mom or the fetus?
Fetus, mom may be asymptomatic, or with only mild disease
what are some findings in a newborn that you should suspect perinatal/congenital infection?
IUGR, hepatomegaly, thrombocytopenia, unusual rash, presence of IgM’s
what viral pathogens are more commonly perinatal infections than congenital?
HIV, and herpes simplex
what are the three infections that can be transmitted through breast milk?
CMV, HIV, HTLV-1
what is the triad of toxoplasmosis infection in a new born?
Choriotretinitis*, intracranial calcification, hydrocephalus
what leads to more severe manifesations of toxoplsmosis? how is this transmitted?
the earlier in pregnancy= more severe, but lower transmission rate
cats are definitive hosts, can also get it eating undercooked meat
hwo do you test for toxoplasmosis?
serology
what type of virus is the guilty party is a new born has probelms with cataracts, heart defects, and defness? can also have a purpuric rash
Toga virus- +ssRNA, Rubella
greatest concern in 1st trimester
how do you diagnose rubella?
serology
what type of virus is CMV?
herpes- dsDNA virus
what is the msot common cause of congenital infection in the US? what is the most common way of transmission?
CMV, in utero is the most common mode of transmission
are primary or recurrent maternal infections more dangerous to the fetus?
primary
what are the symptoms of CMV infection?
microcephaly, jaundice, hepatosplenomegaly, “blueberry muffin rash”
how do you diagnose CMV?
PCR from amniotic fluid, or from urine and oral secretions after birth
is the initial infection of HSV or a reacivation of HSV more dangerous to the fetus?
initial infection- no maternal imunity transfered
what are the three main categories of presentations for neonatal herpes infections?
- mucocutaneous- vesicular rash on skin, eyes, mouth (45%)
- encephalitis- 30%
- disseminated jaundice, fever, rash (25%)
what is the in utero bacterial infection that affects fetuses?
T. pallidium ( syphilis)
what stage is associated with early manifestations ( under 2 in a child)? what about over 2?
under 2= secondary stage
over 2= tertiary
what are some late manifestations of congenital syphilis?
ocular problems, notched teeth, deafness, arthrits, gummas
what is the msost common cause of neonatal sepsis?
Group B strep
what are the stages of presentations with group B strep
early onset= from 24 hours after birth to 6 days
late onset= 4-5 weeks , can last 7 to 89 days
what are some manifestations of fetal group B strep infections?
pneumonia, shock, cellulitis, maningitis, septic athritis
what serotypes of chlamydia are asociated with neonatal infection?
B, and D-K
what does a neonatal infection of chlamydia lead to?
conjunctivits, pneumonia
what is the gold standard of Dx for chlamydia?
culture
what are the manifestations of gonorrhoeae infection in a fetus? how do you DX?
eye infection, septicemia, septic arthritis, meningitis
Dx- gram stain of eye exudate, culture ( thayer martin)
what are the effects of bacterial infections of the fetus?
prematurity and/or congenital disease
what aer the effects of parasitic infections of the fetus?
low birth weight and/or congenital disease
baby is born with scaring lesions on the limbs, and has multiple limb abnormalities, detection of a dsDNA virus is found, what is the most likely culprit?
VZV- leads to limb abnormalities, and scarring lesions
which viral family can lead to hydrops fetalis?
parvovirus B-19, ssDNA, non enveloped
what is the main determinant in the transmission of HIV to a newborn?
the viral load of mom
