You Nasty! Flashcards
TORCH
Toxoplasmosis Other (syphilis) Rubella Cytomegalovirus (CMV) Herpes simplex virus (HSV)
What is a an important contributor to early and later childhood morbidity
infectious acquired in utero or during birth process
What are the only two prenatal screenings done in the U.S.
syphilis and rubella
How does Toxoplasmosis present in the baby?
Triad:
Chorioretinitis
Hydrocephalus
Intracranial calcifications
What is a late finding in toxoplasmosis due to failure to treat
chorioretinitis
What is seen in late finding for toxoplasmosis
intellectual disability, deafness, seizures and spasticity
What is the treatment for Toxoplasmosis
Pyrimethamine and Sulfadizine (folinic acid leucovorin)
Syphilis presentation in the baby?
asymptomatic at birth
How do babies get syphilis?
mother received no prenatal care, no PCN, or inadequate treatment before/during birth
Babies <2 show what syphilis manifestations?
syphilitic rhinitis (snuffles), maculopapular rash (palms), heptaosplenomegaly
Babies > 2 show what syphilis manifestations?
saddle nose, hutchinson teeth, saber shins, mulberry molars
Treatment for syphilis?
paraenteral penicillin
Rubella presentation in the mother?
mild, self limited illness
CRS presentation in the child?
sensorineural deafness, cardiac malformations, radiolucent bone disease, blueberry muffin, growth retardation
Where is CRS usually seen?
in infants who mothers emigrated from countries w/ no rubella vaccine
How is CRS treated?
Prevention is most important for management
Children with CRS are contagious until….
1yr
CMV presentation in baby?
asymptomatic, w/ 10% of symptoms
What is the most common congenital viral infection
Cytomegalovirus (CMV)
How does the mother get CMV?
close contact w/ young children, daycares
What is the most common defect in CMV babies?
Sensorineural hearing loss (1/3 detected @ birth)
CMV children are identified solely on the basis of what?
failed newborn hearing screen
What is the treatment for life threatening CMV?
Ganciclovir IV
What is the treatment for non-life threatening CMV?
Valganciclovir oral
What is the treatment for asymptomatic CMV?
NONE, antiviral is not needed!!
What are most cases of neonatal HSV infection?
Perinatally acquired HSV
How is perinatally HSV transmitted?
through infected maternal genital tract
How do perinatally infected HSV babies present?
normal @ birth
What ways do perinatally acquired HSV develop?
- Localized to skin, eyes, and mouth (SEM)
- Localized CNS disease
- Disseminated disease involving multiple organs
How does a congenital HSV baby present?
Triad:
Skin vesicles
Ulcerations
Scarring
Eye damage, severe CNS (microcephaly or hydranencephaly)
Treatment for Herpes?
Acyclovir
ZIKA presentation in mama?
asymptomatic
low grade fever, rash, arthralgia, conjuctivitis