Perinatal Infections

Front 1

Early Onset Sepsis
-acquired when?
-how?
-progression
-clinical manifestation

Back 1

-within first week
-from maternal blood or ascending intravaginal infection (associated w/ pregnancy complications)

-severe/sudden onset - rapidly progressing
-irreversible shock, respiratory distress (pneumonia), hepatosplenomegaly; multisystem
-higher mortality

Front 2

Early Onset Sepsis
-etiology
-extrinsic factors

Back 2

#1 - Group B strep
#2 - E. coli
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-preterm delivery (no maternal IgG)
-premature rupture of membranes (PROM)
-maternal chorioamnionitis
-fever

Front 3

Late Onset Sepsis
-acquired when?
-how?
-progression
-clinical manifestation

Back 3

-after first week
-nosocomial (NICU or nursery)
-slowly progressive
-focal; CNS involvement (meningitis), vasculitis

Front 4

Late Onset Sepsis
-etiology
-extrinsic factors

Back 4

-CNS (S. epidermidis) - esp. w/ low birth-weight babies
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-seeding of blood from invasive procedures
-heavy antibiotic use --> candida overgrowth

Front 5

Sepsis Prevention

Back 5

-maternal intrapartum antibiotic prophylaxis (IV penicillin)

Front 6

Congenital HIV
-mothers usually are?
-clinical manifestation
-prevention

Back 6

-mothers usually IVDU or sexual partners of abusers
-mothers usually asymptomatic
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-all kids born to HIV+ mothers have antibody but may not be infected (use PCR for DX)
-kids get recurrent bacterial infections (pneumococcal bacteremia)
-Lymphocytic interstitial pneumonitis
-Developmental delays, basal ganglia calcifications
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-maternal anti-virals reduce viral load and probability of vertical transmission

Front 7

Congenital CMV
-mother's clinical presentation
-kid's clinical presentation
-prevention

Back 7

-mother can be asymptomatic or have mononucleosis-like illness
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-kids usually asymptomatic
-small for gestational age (SGA)/IUGR
-hearing loss & mental retardation
-periventricular calcifications
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-limit contact with young kids, hand-washing

Front 8

Congenital VZV
-mother
-kid
-prevention

Back 8

-maternal infection can disseminate --> high mortality in newborn (within 5 days of and 2 days after delivery)
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-mother gets classical rash
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-kid - infection w/in first 20 weeks of gestation --> skin scarring, muscle atrophy, micropthalmia, death
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-VZIG in susceptible mothers

Front 9

Congenital HSV
-usually which virus?
-clinical presentation
-prevention

Back 9

-usually from HSV-2 (STD) in US
-baby aspirates virus during -intravaginal delivery
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-devastating, severe neurologic disease --> lifelong impairment --> institutionalization
-panencephalitis, seizures, vesicular rash
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-C-section for mothers w/ 3rd trimester infections

Front 10

Congenital Parvovirus
-causes what in kids?
-causes what in adults?
-prevention

Back 10

-causes 5th diesase (erythema infectiosum) in kids
-causes arthralgia/arthritis in adults
-slapped cheek rash in kids
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-attacks RBC progenitors --> RBC aplasia
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-can also get hydrops (anasarca) anemia and myocarditis in kids
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-avoid contact with exposed children

Front 11

Congenital Rubella Syndrome

Back 11

Rare due to MMR but still occurs in Central/South America (no MMR)

Associated w/ cataracts, heart defects

Front 12

Congenital Toxoplasmosis
-caused by?
-get from?
-clinical presentation
-prevention

Back 12

-intracellular parasitic protozoan
-swallowed cat feces or uncooked meat
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-kids asymptomatic but develop chorioretinitis, mental retardation, seizures, hydrocephalus
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-avoid raw meat, cats