Flashcards in Micro congenital and neonatal infections Deck (32):
what are the congenital infections?
rubella, CMV, HIV, toxoplasma, treponema, parvovirus B19, HSV, VZV
what are the manifestations of congenital infections?
growth retardation (low birth weight), congenital malformations, stillbirths
what are the perinatal infections?
neisseria gonorrhoeae, chlamydia, HSV, strep B, e coli, listeria
what are the manifestations of perinatal infections?
maningitis, septicemia, pneumonia, preterm labor
what are the postnatal infections?
from breast milk: HIV, CMV, HBV
umbilicus: staph aureus, tetanus
person to person: group B strep, listeria, e coli
what are the postnatal infections manifestations?
minigitis, septicemia, conjunctivitis, pneumonitis
what are the signs of congenital infection?
growth retardation, congential defects, abnormal head size, rash, intracranial calcifications, eye abnormalities, hearing loss, inflammation of CSF, hepatosplenomegaly, hematologic abnormalities, bone lesions
how is definitive diagnosis of congenital infection made?
isolate pathogen from infant!!
what are the congenital infections
Other (syphilis, hep B, VZV, parvovirus B19, HIV, HTLV-1
toxoplasma gondii classic triad
chorioretinitis (can result in vision loss), hydrocephalus, intracranial calcifications
diagnosis of toxoplasmosis
IgM+ in infant is diagnostic
pyrimethamine + sulfadiazine + folinic acid for one year
congenital syphilis manifestations
by 3 months:
large puffy placenta, hepatomegaly, rhinitis (snuffles!), rash, lymphadenopathy
test for t. pallidum
VDRL (venereal disease research lab), darkfield microscopic exam
t. pallidum treatment
microcephaly, PDA (patent ductus arteriosis), cataracts
risk factors for congenital CMV
no prior infection, pregnancy at younger age, first pregnancy, new sex partner during pregnancy, frequent contact with babies/toddlers
-especially PRIMARY infection
most asymptomatic - 10% with symptoms
small size, hepatosplenomegaly, rash, jaundice, chorioretinitis, neuro involvement (microcephaly, seizures, abnormal neuro, feeding difficulties)
congenital CMV diagnosis and treatment
diagnose: PCR on urine or blood
treat: ganciclovir IV or valganciclovie PO
congenital herpes simplex infections - what is worst situation for baby
HSV-2; primary infection ; visible lesions; intrauterine; disseminated infection (causes severe mental impairment)
treatment of HSV
C-section birth, antiviral prophylaxis, acyclovir for infant
congenital varicella syndrome
primary infection in mother damages fetus - limbs and brain development are impaired
congenital varicella treatment and prevention
acyclovir - prevent with vaccination of all seronegative women who reach childbearing age
parvovirus B19 presentation
febrile illness without rash precedes followed by "slapped cheek" rash on face and erythematous maculopapular rash, arthralgia, arthritis
what are the most common causes of neonatal sepsis
group B strep and e coli
risk for chronic infection with HBV
what treatment is used for women with HIV
3 part zidovudine (ZDV) regimen - reduces transmission rate to 2%
-avoid agents with tertogenic effects (efavirenz)
group B strep
encapsulated gram-positive diplococcus - 25% women asymptomatic carriers
what are risk factors for early-onset GBS (group B strep) disease
previous baby with GBS, GBS in urine, fever during labor, heavy maternal colonization, delivery before 37 weeks, premature or prolonged rupture of membranes
what reduces risk of group B strep in babies
IAP intrapartum antibiotic prophylaxis
what are symptoms of GBS infection
1. early onset: respiratory tachypnea, grunting, hypoxia, appears ill, temperature instability, hypotension, shock
2. late onset: sepsis (fever, irritability, lethargy, poor feeding, tachypnea, gruniting apnea), meningitis (bulging fontanel, nuchal rigidity, focal neurologic findings
3. late onset GBS: sepsis with foci in CNS, soft tissues, bones, joints