Pathogen Profiles
This vaccine-preventable viral infection presents classically with cataracts, sensorineural hearing loss, and patent ductus arteriosus.
What is Rubella?
Because serologic tests are unreliable in neonates, this specific direct testing modality is the gold standard for diagnosing congenital CMV.
What is a urine or saliva PCR test?
Symptomatic infants with congenital CMV should receive this oral antiviral medication for up to 6 months to mitigate progressive hearing loss.
What is oral valganciclovir?
Across almost all TORCH pathogens, maternal infections contracted during this specific trimester pose the highest teratogenic risk and produce the most severe anomalies.
What is the first trimester?
Because it is the most common infectious cause of sensorineural hearing loss in children and can have a delayed onset, infants with congenital CMV require annual monitoring of this specific system throughout early childhood.
What is the auditory system? Needs to follow with audiology.
The classic triad of chorioretinitis, hydrocephalus, and intracranial calcifications is caused by this parasitic pathogen.
What is Toxoplasma gondii?
This serologic assessment measures the binding strength between an IgG antibody and a pathogen, and is vital for determining if a maternal infections occurred recently or in the past.
What is an IgG avidity test?
Symptomatic neonates or perinatally exposed infants with clinical suspicion of HSV should immediately be started empirically on this IV medication.
What is IV acyclovir?
While hematogenous transplacental passage is the most common vertical route for CMV and Toxoplasma, HSV is primarily transmitted to the fetus via this route.
What is intrapartum (or perinatal/passage through the birth cana)?
To verify the success of neonatal eradication therapy for congenital syphilis, this specific test much be monitored post-discharge every 2-3 months.
What is the RPR test?
This pathogen is characterized by a presentation of microcephaly, hearing loss, and periventricular calcifications.
What is CMV?
This is the diagnostic strategy of choice to confirm past maternal exposure to syphilis, whereas maternal and infant RPR titers must be compared to check for active infant infection.
What is a treponemal test (TPPA)?
A combination regimen of pyrimethamine, sulfadiazine, and folic acid is the standard treatment for confirmed cases of this specific infection.
What is toxoplasmosis?
This viral pathogen is an outlier where the risk of sensorineural hearing loss actually increases if the maternal infection is acquired during the second or third trimester.
What is CMV?
Due to the severe risk of progressive vision loss from chorioretinitis, infants diagnosed with congenital toxoplasmosis require routine surveillance using this test.
What is a fundoscopic exam?
A classic neonate with "snuffles," a widespread rash, and hepatosplenomegaly is highly suspect for this congenital infection.
What is syphilis?
When performing a urine or saliva PCR for suspected congenital CMV, testing must occur within this precise number of days after birth, as results obtained later may only reflect a postnatally acquired infection.
What is 21 days?
The treatment duration of choice for an infant with symptomatic or uncertain congenital syphilis requires this many days of IV pen G.
What is 10 days?
Unlike recurrent maternal HSV episodes, a primary maternal HSV infection contracted during this trimester presents with absolute highest risk of vertical transmission due to a lack of protective maternal antibodies.
What is the third trimester?
While infants treated for perinatal HSV require auditory and neurologic tracking for up to 2 years, infants testing positive for this virus also need a structured lifelong monitoring protocol for this virus.
What is HIV?
Though rare at 1 in 3,000 to 1 in 20,000 live births, this infection presents with vesicular lesions, encephalitis, or hepatic failure, and carries immensely high morbidity and mortality.
What is HSV?
Long-bone radiographs are a key adjunctive diagnostic tool specifically utilized when evaluating a neonate for this congenital infection.
What is congenital syphilis?
To prevent vertical transmission in high-resource nations, an infant born to a well-suppressed HIV-positive mother who opts for formula feeding should receive 4-6 weeks of prophylaxis with this medication.
What is Zidovudine?
To prevent intrapartum transmission, a laboring mother presenting with active genital herpes lesions or prodromal symptoms requires this immediate management choice.
What is elective/immediate c-section delivery?
Routine brain MRI monitoring is recommended for these infections (2). EEG recommended for this infection (1).
What are CMV and toxo?
What is toxo?