MedLecturesMadeEasy's video: Vertically transmitted infections TORCH infections

This video is on infections that are vertically transmitted from mother to fetus during pregnancy, including TORCH infections and TORCH syndrome. This presentation was created using Google Slides. ADDITIONAL TAGS: Infection: Symptoms / signs / findings: Diagnosis: Treatment (for baby): Risk/how did mom get it? Maternal symptoms: Screening / prevention: Toxoplasmosis Diffuse intracranial calcifications (particularly in basal ganglia), chorioretinitis, hydrocephalus / ventriculomegaly, seizures; HSM, FGR, visual disturb, developmental delay, Toxoplasma serology or PCR Pyrimethamine, sulfadiazine, folinic acid / leucovorin Cat feces, cysts in soil / unwashed produce, undercooked/raw meat Fever, malaise, cervical LAD, HSM, maculopapular rash; resolves spontaneously Toxo antibodies in 1st trimester Syphilis (Other) Osteoarticular destruction (eg, Hutchinson (notched) teeth, saddle nose); maculopapular rash on palms/soles; LAD; saber shins RPR, FTA-ABs Darkfield (old) Penicillin STD Painless chancre (1º) → rash on palms/soles, fever (2º) → neuro, tabes, AR pupils (3º) Treat mom with penicillin (even if allergic → test IgE → desensitize) Rubella (German measles) Cataracts (leukocoria [white pupillary reflex]), heart defects (PDA, VSD), SNHL, extramedullary hematopoiesis (blueberry muffin baby). IUGR and abortion if in 1st trimester Serology (+high avidity IgG) None :( Contacts → respiratory droplets Fever, cephalocaudal spread maculopapular rash (like in children); + arthralgias, arthritis 1st trimester screen; MMRV vaccine (not during pregnancy) Cytomegalovirus (most common) Bilateral periventricular calcifications; deafness (SNHL), thrombocytopenia, chorioretinitis petechiae; blueberry muffin; HSM; growth restriction, microcephaly; jaundice PCR test; viral culture of urine/saliva Valganciclovir; supportive care Contacts → urine / saliva; work w young children (teacher, daycare) Often asymptotic, or nonspecific mild viral illness Avoid sick kids Herpes Mucocutaneous vesicles, keratoconjunctivitis (dendritic branching pattern on cornea); seizures, fever, lethargy, temporal lobe hemorrhage/edema; systemic (sepsis, pneumonia, hepatitis) Culture of surface; PCR of blood or CSF (don’t use Tzanck anymore Acyclovir STD Painful burning genital lesions (vesicles on erythematous base) If +hx, prophylax from 36 weeks with acyclovir. If active lesions at delivery → c/section Vertically transmitted infections Varicella-zoster: Transmxn: Chickenpox contacts → aerosolized droplets Sx: Limb hypoplasia, vesicular eruption → cutaneous scars, chorioretinitis, cortical atrophy, cataracts, fever, systemic (hepatitis, pneumonia, meningitis, encephalitis Tx: Acyclovir. + PEP: if mom exposed on DOB-5d to DOB+2d, give VZIG Screen/prevent: 1st trimester screen; MMRV vaccine (not during pregnancy) Listeria monocytogenes: Transmxn: food → bacterial invasion of intestinal epithelium → transplacental to fetus Sx: neonatal febrile gastroenteritis → invasive disease (sepsis, meningitis). Multiple abscesses and granulomas, a.k.a. Granulomatosis infantiseptica Dx: Gram+ rods on culture Tx: gastroenteritis gets supportive care; invasive dz gets abx Screen/prevent: pregnant moms avoid raw meats/veggies, unpasteurized dairy, deli meats, decaying vegetation -Hemolysis → high bili → jaundice +/- kernicterus -Extramedullary hematopoiesis → hepatosplenomegaly, lymphadenopathy, widespread purpura (blueberry muffin baby) -Low platelets → petechiae