Flashcards in 05-06 Infections in Early Life Deck (16):
What congenital infections do you worry about?
Toxo, VZV, Rubella, CMV, HSV/HepB/C/HIV, Enteroviruses, Syphilis
Complications of congenital rubella syndrome?
Hearing impairment, heart defect, PDA, microceph, low birth weight, MR, purpura (PIC), retinopathy (PIC) and on and on
Risk of maternal to fetal transmission w/o breastfeeding w/o tx?
Risk of maternal to fetal transmission WITH breastfeeding w/o tx?
What peripartum infx should you worry about?
HSV, GBS, E. coli
Neonatal HSV Complications
encephalitis: can lead to CP
Bugs that cause resp tract infx (airways) in kids?
RSV, para-flu, flu, human metapneumovirus
Types of otitis media
1. secretory (transudate build-up)
2. Acute Suppurative Otitis (purulent exudate)
Most common bugs causing Acute Suppurative Otitis Media in kids?
35% Strep pneumo
20% H. flu
15% Moraxella catarrhalis
<5% S. aureus
25% no org found
Acute Suppurative Otitis Media
—Major Adverse Outcomes if not tx'd
Watchful Waiting or give Rx w/ instructions to fill in two days if not better if reasonable in older infants/children (per AAFP)
— > 75% of cases resolve without therapy within 5-10 days
—First line: amoxicillin
—2nd line: amoxicillin + clav OR
—Beta-lact allergy: clinda or azithro
Major Adverse Outcomes w/o Tx
—CHRONIC develops in 10% of untreated pts which leads to:
—CN V palsy
—mastoiditis -> brain abscess
—osteomyelitis of the petrous ridge of temporal b
—venous sinus thrombosis
Which Ig's cross the placenta?
Only IgG for the most part
—IgM does not, so can be used in dx in infants
Congenital CMV Infx
1% of babies have detectable CMV infx at birth
—can cause sensorineural hearing loss in infancy
Congenital infx timing
Early-to-mid gestation is more risky and can cause all kinds of crazy problems:
—pretty much any abnormality imaginable
Acute Infx in late pg or close to birth
—present days-weeks post-partum
Subsequent Reactivation: infancy and childhood
Do C-sections lower the rate of HIV transmission in infants of un- or under-treated mothers?
Herpes Simplex in infants
—Is Rx effective?
Newborns susceptible 4-8wks
—reactivates from latent states
—Rx effective if started early
**Vesicles may appear only later or never
—SEM: skin, eyes, mouth vesicles
—Disseminated: 29% mortality
—CNS only: lethargy, szs (4% mort)
—Congenital: vesicles, brain damage, microcephaly