1. vesicular rash on skin, eyes, mouth 2. disseminated disease 3. CNS disease

1. previous GBS infected infant 2. GBS bacteruria during this pregnancy 3. GBS positive 4. GBS unknown and premature ; prolonged rupture; maternal fever

ID Flashcards by Mary-Elizabeth Lago

petechia, red macules that progress to pustules- histology shows granulomas;

can also have purulent conjunctivitis, plaques on umbilical cord , granulomas can be found anywhere

skin findings associated with early onset disease

listeria

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CMV pearls

DNA virus

common presentation - IUGR, small head, enlarged liver, low platelets

treatment with gancyclovir reduces the severity of hearing loss

primary infection is more likely to affect fetus , worse earlier in pregnancy

jobs that work with small kids are higher risk

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early onset sepsis pearls

more common in who
MCC bug for term/preterm

10x more common in low birth weight
GBS for term, Ecoli for preterm
type 3 GBS is most commonly associated with late onset sepsis

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Toxo pearls
How?
Symptoms?
Premies
Tx

fecal-oral

kittens

most are asymptomatic

preterm infants may show signs earlier than term- eyes and CNS disease

1 yr treatment with pyrimethamine-sulfadiazine and folinic acid

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HSV presentations

vesicular rash on skin, eyes, mouth
disseminated disease
CNS disease

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HSV pearls

does treatment prevent neurologic outcomes
will everyone have skin lesi

treatment with acyclovir does not prevent neurological sequelae of CNS disease

1/3 will not have skin lesions

c-section is preventative is mom has active lesions

infection can happen without active lesions or prior history

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omphelitis + recurrent infections + delayed umbilical cord separation

Leukocyte adhesion deficiency

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CMV precautions

standard

passed through secretions, milk, placental , sex

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rubella precautions

droplet and contact

RNA
respiratory secretions

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HSV precautions

contact

DNA

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toxoplasmosis precautions

standard

transplacental or undercooked meat/cat

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TB precautions

contact and airborne
can be droplet aerosolized, also can get it from mucous membrane contamination , blood or amniotic fluid

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varicella precautions

airborne and contact

respiratory droplets, contact with raw
DNA

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RSV

contact

RNA

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parvo precautions

droplet

DNA

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listeria precautions

standard

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GBS prophy if

previous GBS infected infant
GBS bacteruria during this pregnancy
GBS positive
GBS unknown and premature ; prolonged rupture; maternal fever

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signs of chorioretinitis by findings

salt and pepper

yellow white exudates

necrotizing

salt+ pepper
- syphilis
- rubella

yellow-white exudate
- HSV
-CMV
- candida

necrotizing
- too

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galactosemia has increased risk of what

Ecoli infections

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neonates can get a uti by

ascending infection or blood spread

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organisms for meningitis

GBS
Ecoli - K1
listeria
klebsiella + enterboacter
flu
neisseria

in decreasing order

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early onset sepsis organisms

GBS #1 40@
ecoli #2 28%
strep especies - 10%
enterococcus and staph 2-3%
listeria <1 %
one source included -non-typable Hflu

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late onset sepsis organisms

coagulase neg staph #1
staph
pseudomonoas
gbs
ecoli
listeria

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chocolate colored like amniotic fluid, rash with granulomas on histology

gram postive rod

late onset meningitis may have increase CSF monos

listeria

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syphilis can be transmitted

by transplacental or contact with active lesion at delivery

syphilis signs Nose Liver Eyes Bone Placenta

copius nasal secretions hyperbili chorioretinitis bilateral destruction of proximal medial metaphysis/ periostitis large placenta in addition to he usually things

infections with increased risk of still birth

listeria, syphilis and parvo

infection that increases with gestational age

toxo

infection that can happen anytime during pregnancy but is worse when acquired later

syphilis

infection is more likely at the beginning and end of pregnancy, but more severe if acquired early

rubella

infection worse if acquired early

CMV

Caoag neg staph infection is real if

2 + cultures from different sites Goes in 15 hrs Exam+ Catheter present >50 CFU

Most common cause of conjunctivitis in less than 1 month

Chlamydia

Lab finding for neonatal chlyamydia infection

Eosinophilia

brain abscesses

citrobacter and enteronbacter

ecoli with K1 antigen

increased risk of meningitis

galactosemia association

increased UTI with Ecoli

initial gram neg treatment

amp/gent double coverage

double coverage required for all of treatment gram neg

enterobacter, citrobacter, serrate, pseudomonas

associated with chorioamonitis , a positive culture in a baby doesn't mean true infection, can cause pneumonia /sepsis/meningitis

ureaplasma urelyticum treat with erythromycin, if CNS and kid is sypm then tetracycline

HSV pearls 1. primary vs secondary lesion at birth 2. of the babies who are infected is it usually a primary or secondary 3. % whos moms were asymptomatic

1. 25-60% of babies with primary lesion will get infected, compared to less than 5% of secondary 2. secondary bc its more common 3. 75%

DNA viruses

CMV, HSV, EBC, Varicella, HHV6, Hep B

SEM disease

HSV earlier onset most common form of infection skin lesions - papularvesicular, conjunctivitis/chorioretinitis treat to prevent CNS disease risk of neurological sequelae if it reoccurs more than 3 times

HSV encephalitis and systemic infection

encephalitis is slightly more common systemic infection has worse outcomes may be liver/adrenal dysfunction, coagullopathy and shock 60% have skin involvement systemic with higher mortality

CSF with elevated protein, and pleocytosis- mononuclear cells

HSV

detected when HepB is replicating

HepBeAg

acute hep infection

HepBsAg

chronic infection hep B

positive HepBsAg, Anti Hep-Bc

Hep B status unknown

Hep B vaccine in 12 hrs, HBIG in 7 days

hep B postive

give vaccine and HBIG in 12 hours

anemia and CHF may lead to hypos , myocarditis, thrombocytopenia, neutropenia, liver disease

parvo

VZIG- does what for side effect

lengthens incubation time of varicella

varicella infection between 8-20 wks

high risk of congenital varicella syndrome

varicella infection during second half of pregnancy but more than 21 days prior to delivery

low risk of congenital syndrome

varicella between 5 days before deliver and 2 days after

greatest risk of acute infection

indications for VZIG

preterm infant less than 28 wks or 1k preterm infant older than 28, more than 1k who's mom never had chickenpox infant who's mom is infected 5 days before delivery to 2 days after infant who is exposed after 2 days of life who's mom never had chickenpox can get it but is not an AAP rec

most common GBS serotype

maternal GBS screening has shown to

only decrease EOS

osteomyelitis pearls

1. neonates are a higher risk compared to older kids 2. neonates have more rapid bone formation 3. neonates are more likely to have septic arthritis 4. bony destruction is less common 5. MCC site = metaphysis 6. can lead to ephysistis

placenta for CMV

villous damage with thrombosis, colitis with inclusion body cells and hemosiderin

placenta for syphilis

hydrops and round cell infiltration caused by maternal immunocytes

CMV hearing loss

bilateral progressive correlates with presence of periventricular calcifications sensorineural

toxo - worst timing for symptoms vs greatest time for infection

higher risk of infection with later gestation the earlier in pregnancy - worse symptoms

toxo workup

1. Ig G + M + A antibodies if positive then send PCRs for urine, CSF and serum

confirmation of toxo

Positive IgG after 1 yr IgM after 5 days IgA after 10 days positive PCR

maternal treatment for toxo

spiramycin or after 18 wks or during third trimester - pyrimethamine + sulfadiazine

supplement with pyrimethamine and sulfadiazine

Folic acid to prevent neutropenia

greatest risk of transplacental transmission in 3rd trimester

rubella (1st and 3rd) toxo coxsackie

leukoreduction of blood products reduces transmission of

CMV

things transmitted in breastmilk

HIV hepB CMV rubella HSV

encapsulated organisms

Yes Some Killer Bacteria Have Pretty Nice Capsules yersinia, strep pneumo/salmonella, klebsiella, bacillis anthracis, H flu, pseudomonas, neisseria meningitides , crypoto

gram positive that is resistant to all cephalosporins

enterococci

beta-lactamase producing bacteria

serrate, pseudomonas, acinetobacter, citrobacter, enterobacter SPACE

white spots on umbilical cord and a septic appearing baby

congenital cutaneous candidiasis

mcc early viral pneumonia

HSV

congenital pneumonia

diagnoses in the first 3 days from aspiration of infected fluid, transplacentally / hematogenous , ascending

chlamdyia trachomtis causes what type of pneumonia

late onset - 2-4 weeks of life

most common problem for asymptomatic untreated toxo

chorioretinitis

fungal infection locations

CNS, eyes, urine and kidneys

rash of congenital syph

vesiculobullous mucocutaneous lesions on palm an soles

distinguish CMV and rubella

rubella = cataracts

HepB infection is higher likelihood if

HBeAg positive and viral load high

can infants BF with mothers positive for Hep B

yes with exposure prophylaxis

Risk of transplacental transmission of Syphilis

If first figure your seconddegree Syphilis, it’s 60 to 100%!

Holder pasteurization and activates, which viruses

HIV and cmv

Airborne precautions for

Tb Messes Varicella

Contact precautions for

Hsv Enterovirus Rsv Gi bugs

Cephalosporins

1 cephalexin 2 cefoxitin 3 cefotaxime, ceftazidime , ceftriaxone 4 cefepime 5 cefteroline

ID Flashcards

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