Congenital Rubella Syndrome

Question 1

A full-term neonate was seen on the post-natal ward and referred for an urgent neonatal consultation. Her mother had recently entered the country as a refugee and presented in labor, with no preceding antenatal care. On examination, her baby was found to have microcephaly, bilateral cataract, and sensorineural deafness.

Answer 1

a) What is the most likely diagnosis of this case?

*Congenital Rubella Syndrome (CRS)
عرفتها ازاي ؟؟؟
*The triad of microcephaly, bilateral cataracts, and sensorineural deafness is highly suggestive of CRS.
*Occurs when the mother contracts rubella virus during early pregnancy.
*Lack of antenatal care and recent refugee لاجئstatus (potential lack of vaccination) increases the risk.

Question 2

b) What are other clinical features of this syndrome?

Answer 2

A-Early (at birth or neonatal period):
1-Ocular: Cataracts, glaucoma, retinopathy.
2-Auditory: Sensorineural hearing loss (most common feature).
3-Neurologic: Microcephaly, developmental delay, meningoencephalitis.
4-Cardiac: Patent ductus arteriosus (PDA), pulmonary artery stenosis.
5- Dermatologic: “Blueberry muffin” rash (dermal hematopoiesis
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6-Hepatosplenomegaly, jaundice, thrombocytopenic purpura.
B-Late-onset complications:
1-Developmental delay,
2- Diabetes type 1
3-Progressive rubella panencephalitis (rare but severe).

Question 3

c) What is the differential diagnosis of this case?

Answer 3

TORCH
Toxoplasmosis
Others:Syphilis, Zika, Parvovirus B19)
Rubella
Cmv
Hsv