5/5 Infections in Early Life (Ch 22/PPT) Flashcards Preview

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Flashcards in 5/5 Infections in Early Life (Ch 22/PPT) Deck (32)
1

ToRCHHeS?

TOxoplasmosis
Rubella (German Measles)
CMV
HIV
Herpes Simplex Virus -2
Syphilis

2

Transmission of neonatal toxoplasmosis?

Cat feces or ingestion of undercooked meat

3

neonatal manifestations of toxoplasmosis?

Classic Triad:
Chorioretinitis
Hydrocephalus
Intracranial calcifications (basal ganglia)

4

Transmission of neonatal rubella?

Respiratory droplets

5

neonatal manifestations of rubella?

Classic Triad:
PDA
Cataracts
Deafness
+ “blueberry muffin” rash

6

transmission of CMV?

Sexual contacts, organ transplants

7

neonatal manifestations of CMV?

Sensorineural hearing loss
seizures
petechial “blueberry muffin” rash
periventricular calcifications

8

transmission of neonatal Herpes Simplex Virus -2

Skin or mucous membrane contact (ie transplacental)

9

neonatal manifestations of Herpes Simplex Virus -2

Encephalitis (seizures)
Herpetic (vesicular) lesions

10

transmission of neonatal HIV

Risk of transmission during
- antenatal: 10-25%
- labor/delivery: 35-40%
- breast feeding: 35-40%

11

neonatal manifestations of HIV

Recurrent infections
Chronic diarrhea

12

transmission of neonatal syphilis

Sexual contact

13

neonatal manifestations of syphilis

Stillbirth, hydrops fetalis

If child survives, often presents with rhagades (linear scars at the angle of mouth), snuffles (nasal discharge) that is full of syphilis spirochetes, notched teeth, saddle nose, short maxilla, saber shins, CN8 deafness

14

etiologies of Meningitis in newborns (0-6mo)?

Group B streptococcus – Strep. agalactiae
Listeria Monocytogenes
E. Coli

15

how is Group B streptococcus – Strep. agalactiae acquired?

GPC – colonizes mom’s vajj, but can cause pneumonia, meningitis and sepsis in babies
Pregnant women are screened at 35-37wks, and those with (+) cultures receive penicillin prophylaxis

16

How is Listeria Monocytogenes acquired?

features of bug?

GPR – intracellular microbe with classic tumbling motility –allows evasion by antibody; ONLY GP to produce LPS!!

acquired by ingestion of unpasteurized dairy products, deli meats or transplacental transmission or vaginal transmission

17

4 causes of Meningitis in infants (6mo-6yr)?

What is unique about 3 of these bugs?

S. pneumoniae
N. meningitides
H. influenza Type B
Enterovirus (PicoRNAviruses)

top 3 secrete IgA protease in order to colonize respiratory mucosa
all of these are also encapsulated (antiphagocytic virulence factor)

18

Enterovirus (PicoRNAviruses)?

Poliovirus
Echovirus
Rhinovirus
Coxsackievirus
HAV

(PERCH)

All fecal-oral spread except Rhinovirus

19

etiologies of Respiratory Infections?

pathogenesis?

RSV
Parainfluenza Virus

both paramyxoviruses - both contain a surface F (fusion) protein, which causes respiratory epithelial cells to fuse and form multi-nucleated cells

20

sx of RSV?

trmt?

Bronchiolitis, pneumonia

Trmt: Palivizumab (mAb against F protein) – prevents pneumonia caused by RSV in premature infants

21

sx of parainfluenza virus?

Croup (seal-like barking cough)

22

otitis media is commonly caused by these 3 bugs

Strep Pneumoniae
Haemophilus influenza
Morazella catarrhalis

23

otitis media is commonly in what patient population?

<2 yo

24

what is Secretory Otitis Media occur?

trmt?

obstruction of auditory tube → accumulation of transudate with decreased pressure within middle ear and diminished mobility of tympanic membrane → diminished hearing

oral antibiotics

25

what is Acute Suppurative Otitis Media occur?

complications of this?

trmt?

obstruction of auditory tube due to recent colonization of nasopharynx with pathogenic bacteria → purulent exudate with increased pressure in middle ear with bulging of tympanic membrane

CN7 paralysis
mastoiditis (→brain abscess)
osteomyelitis “petrositis”
venous sinus thrombosis
“lateral sinus thrombosis” → otitic hydrocephalus

trmt:
- treatment: observation, antibiotics, myringotomy (incision made to relieve pressure caused by excess fluid buildup)
- 1st line: amoxicillin or if Strep. pnemo: amoxicillin clavulanate
- persistent : cefpodoxime
- recurrent: cefuroxime or ceftriaxone
- ß-lactam allergy: clindamycin or azithromycin

26

Strep Pneumoniae sx?

Meningitis
Otitis media
Pneumonia
Sinusitis

27

features of Strep Pneumoniae?

Most are OPtochin sensitive

Secretes IgA protease to colonize respiratory mucosa

Associated with
- “rusty colored sputum”
- sepsis in sickle cell anemia and splenectomy

28

Haemophilus influenza sx?

HaEMOPhilus
- Epiglottitis (cherry red in children)
- Menigitis
- Otitis media
- Pneumonia

29

Haemophilus influenza features?

GNR transmitted via aerosol droplets

Most invasive type: capsular type B (B for baby?!)

Produces IgA protease to colonize respiratory mucosa

Requires chocolate agar w/ Factor V (NAD) + X (hematin) or co-culture w. S. aureus, which provides factor V

30

trmt for Haemophilus influenza?

prophylaxis for close contacts?

vaccine?

- Mucosal infections: amoxicillin-clavulanate

- Meningitis: ceftriaxone

- Prophylaxis for close contacts: Rifampin

- Vaccine – contains type B capsular polyssacharide conjugated to diphtheria toxoid or other protein (given btwn 2-18mo)

31

what is Morazella catarrhalis?

GN diplococcus
Predilection for URT – cause otitis media, bronchitis, sinusitis, and laryngitis

32

How does the timing of the infection occurred during pregnancy affect the outcome?

early to mid-gestation:
- congenital defects in various organ systems: skin, CNS, blood, cardiovascular, musculoskeletal, pulmonary, etc

late pregnancy-birth (acute):
- no congenital defects
- manifestations range from mild-severe
- frequent reactivation during infancy and childhood (ie VZV, HSV, CMV)