Micro - Systems (ToRCHeS infections & Red rashes of childhood)

Question 1

What is the defining feature of ToRCHeS infections? How are they transmitted?

Answer 1

Microbes that may pass from mother to fetus. Transmission is placental in most cases, or via delivery (especially HSV-2).

Question 2

What are 4 nonspecific signs common to many ToRHCeS infections?

Answer 2

Nonspecific signs common to many ToRCHeS infections include hepatosplenomegaly, jaundice, thrombocytopenia, and growth retardation

Question 3

Which group of microbes are collectively known to pass from mother to fetus? How are they transmitted, and which is a unique consideration in that regard?

Answer 3

ToRCHeS infections: Toxoplasma gondii, Rubella, CMV, HIV, Herpes simplex virus-2, Syphilis; Transmission is placental in most cases, or via delivery (especially HSV-2).

Question 4

Besides the ToRCHeS infectious agents, what are 4 important infectious agents of relevance? With what condition is each associated (that is relevant/related to ToRCHeS distinguishing feature)?

Answer 4

Other important infectious agents include (1) Streptococcus agalactiae (group B streptococci), (2) E. coli, and (3) Listeria monocytogenes - all causes of meningitis in neonates. (4) Parvovirus B19 causes hydrops fetalis.

Question 5

How is Toxoplasma gondii transmitted?

Answer 5

Cat feces or ingestion of undercooked meat

Question 6

How is Rubella transmitted?

Answer 6

Respiratory droplets

Question 7

How is CMV transmitted?

Answer 7

Sexual contact, organ transplants

Question 8

How is HIV transmitted?

Answer 8

Sexual contact, needlestick

Question 9

How is Herpes simplex virus-2 transmitted?

Answer 9

Skin or mucous membrane contact

Question 10

How is Syphilis transmitted?

Answer 10

Sexual contact

Question 11

What are the maternal versus neonatal manifestations of Toxoplasma gondii?

Answer 11

MATERNAL - Usually asymptomatic; lymphadenopathy (rare); NEONATAL - Classic triad: chorioretinitis, hydrocephalus, and intracranial calcifications

Question 12

What are the maternal versus neonatal manifestations of Rubella?

Answer 12

MATERNAL - Rash, lymphadenopathy, arthritis; NEONATAL - Classic triad: PDA (or pulmonary artery hypoplasia), cataracts, and deafness +/- “blueberry muffin” rash

Question 13

What are the maternal versus neonatal manifestations of CMV?

Answer 13

MATERNAL - Usually asymptomatic; mononucleosis-like illness; NEONATAL - Hearing loss, seizures, petechial rash, “blueberry muffin” rash

Question 14

What are the maternal versus neonatal manifestations of HIV?

Answer 14

MATERNAL - Variable presentation depending on CD4+ count; NEONATAL - Recurrent infections, chronic diarrhea

Question 15

What are the maternal versus neonatal manifestations of Herpes simplex virus-2?

Answer 15

MATERNAL - Usually asymptomatic; herpetic (vesicular) lesions; NEONATAL - Encephalitis, herpetic (vesicular) lesions

Question 16

What are the maternal versus neonatal manifestations of Syphilis?

Answer 16

MATERNAL - Chancre (primary) and disseminated rash (secondary) are the 2 stages likely to result in fetal infection; NEONATAL - Often results in stillbirth, hydrops fetalis; if child survives, presents with facial abnormalities (notched teeth, saddle nose, short maxilla), saber shins, CN VIII deafness

Question 17

If a neonate has rhagades (linear scars at angle of mouth), snuffles (nasal discharge full of infectious agent), and centrally notched, widely spaced incisors (i.e., Hutchinson teeth), what infection does he/she most likely have?

Answer 17

Congenital syphilis

Question 18

Name 7 infectious agents that cause red rashes in childhood.

Answer 18

(1) Coxsackievirus type A (2) HHV-6 (3) Measles virus (4) Parvovirus B19 (5) Rubella virus (6) Streptococcus pyogenes (7) VZV

Question 19

What is the syndrome/disease associated with coxsackievirus type A?

Answer 19

Hand-foot-mouth disease

Question 20

What is the syndrome/disease associated with HHV-6?

Answer 20

Roseola

Question 21

What is the syndrome/disease associated with Measles virus? Give 2 names for this.

Answer 21

Measles (Rubeola)

Question 22

What is the syndrome/disease associated with Parvovirus B19? Give 2 names for this.

Answer 22

Erythema infectiosum (fifth disease)

Question 23

What is the syndrome/disease associated with Rubella virus?

Answer 23

Rubella

Question 24

What is the syndrome/disease associated with Streptococcus pyogenes?

Answer 24

Scarlet fever

Question 25

What is the syndrome/disease associated with VZV?

Answer 25

Chickenpox

Question 26

What infectious agent causes Hand-foot-mouth disease? What is the clinical presentation?

Answer 26

Coxsackievirus type A; Vesicular rash on palms and soles, Vesicles and ulcers in oral mucosa

Question 27

What infectious agent causes Rosela? What is the clinical presentation? What patient population does it usually affect?

Answer 27

HHV-6; A macular rash over body appears after several days of high fever, Can present with febrile seizures, Usually affects infants

Question 28

What infectious agent causes Measles (Rubeola)? What kind of pathogen is it? What is the clinical presentation?

Answer 28

Measles (Rubeola); A paramyxovirus; Beginning at head and moving down, Rash is preceded by cough, coryza, conjunctivitis, and blue-white (Koplik) spots on buccal mucosa

Question 29

What infectious agent causes Erythema infectiosum (fifth disease)? What is the clinical presentation?

Answer 29

Parvovirus B19; "Slapped cheek" rash on face (can cause hydrops fetalis in pregnant women)

Question 30

What infectious agent causes Rubella? What is the clinical presentation?

Answer 30

Rubella virus; Rash begins at head and moves down --> fine truncal rash, Postauricular lymphadenopathy

Question 31

What infectious agent causes Scarlet fever? What is the clinical presentation?

Answer 31

Streptococcus pyogenes; Erythematous, sandpaper-like rash with fever and sore throat

Question 32

What infectious agent causes Chickenpox? What is the clinical presentation?

Answer 32

VZV; Vesicular rash begins on trunk, Spreads to face and extremities with lesions of different ages