If something is a congenital infection then it occurs within 72 hours of birth.

Mcc of aquired infection in the neonatal period is hospital acquired.

CONGENITAL Infx:
• TOXOPLASMOSIS: congenital or acquired (unwashed fruits its the cyst that is infectious)

sx: Sabina Pinkerton triad: hydrocephalus, conjunctivitis-vasculitis, intracranial calcification

consequences: hepatosplenomegaly, pneumonia, endocarditis, psychomotor retardation

SEROLOGICAL DX:
– check toxoplasmosis antibodies against IgM and IgG with ELISA

Treatment:
for neonate: Sulfadiazine, pirymetamin and folic acid

for pregnant woman: spiramycin with dosage depending on clinical sx

RUBELLA
• a single-stranded RNA virus
• vertical infectio, greatest risk of deformity is if it occurs in the first trimesters
• sx: Greggs triad: cataracts, galucoma, deafness, small eyes, heart defects
• diagnosis:
◦ IgM antibodies
◦ 4x more IgG within 2 weeks
Treatment:
only symptomatic

CMV
• one of the MC intrauterine infections, the mother usually doesnt have symptoms
• route of infection:
◦ placenta
◦ blood transfusion contaminated with CMV
◦ going through the birth canal
◦ breast milk
• clinical sx
• aundice, hepala- and splcnomegalia, hemorrhagic diathesis, inflammation
◦ ptuc, light up the brain, glow the retina and choroid, hydrocephalus
• dx
• tx
Clinical symptoms
• Jaundice, hepatospenomegaly, hemorrhagic diathesis, pneumonia, meningitis, retina and choroid -itis,
hydrocephalus, microCEPHALY, intracranial calcification, psychomotor developmental delay.
Diagnostics
• fetal ultrasound findings (growth retardation, microcephaly, brain calcifications)
virus + in amniotic fluid.
• IgM antibodies and CMV DNA via PCR
• Virus present in urine/ blood of infants.
Treatment
• Ganciclovir (disrupts the synthesis of DNA ) - it is administered intravenously
dose of 5 mg / kg every 12 hours;
duration of therapy depends on the response
• Foskarnet (inhibits DNA polymerase ).

HSV

Clinical symptoms
• bullae on skin.
• inflammation of the oral cavity and conjunctivitis
• Hepalsplcnomcgalia, jaundice.
• generalized infectio with CNS involvement (the most severe form of the disease) with high excentricity coefficient).
Diagnostics
virus can be found in: cerebrospinal fluid, conjunctivitis, blood, stool.
• PCR to find DNA virus
Treatment
• Aciclovir (10 mg / kg every 8 hours i.v. for 10-14 days).
• eye complications: 1% tryfluridin drops

enterovirus: ECHO/COXSACKI/POLIO
mode of infection:
bloodstream, vertical (from the mother), horizontal (from another person).
Clinical symptoms
• Symptoms of sepsis.
• A patchy rash.
• DIC
• Light up the meninges.
Diagnostics
Virological examination of feces, throat swabs for the presence of a virus.
Treatment
Symptoms.
CONGENITAL SYPHYLUS

Epidemiology
Untreated mother's infection with Treponema pallidum within the frist two years may cause:
• death of the fetus, premature birth, congenital syphillis in early or late form.

Clinical symptoms
Early form (symptoms of the disease after up to two years of age):
- maculopapular rash,
- hcpatosplenomegaly
- syphillus snuffles - classic symptom,
- eye changes,
- bone changes ("bones eaten by moths"),
- CNS manifestations
Late form (Hutchinson's triad):
- distortion of teeth,
- eye changes,
- deafness.
Diagnostics
• VDRL -
• specific antigens of spirochetes:
-FTA-ABS - the test of irnmunofluoroscarity of corpses in modification ab-
sorption (Fluoroscent TreponemalAntibody Absorbent Test),

- TPHA - hemagglutination test (Treponema Pallidtsm H emaggluti! La-

tionAssay).
- PCR
TREATMENT:
Early congenital syphilis - bcnzatin penicillin IV At a dose of 50,000 units/ kg every 12 hours for 10-14 days.

Wiki:

The face of a newborn infant displaying snuffles indicative of congenital syphilis

Hereditary syphilis: radiating fissures of the lips.

This is a subset of cases of congenital syphilis. Newborns may be asymptomatic and are only identified on routine prenatal
screening. If not identified and treated, these newborns develop poor feeding and runny nose. By definition, early congenital
syphilis occurs in children between 0 and 2 years old. [2] After, they can develop late congenital syphilis.
Symptomatic newborns, if not stillborn, are born premature, with an enlarged liver and spleen, skeletal
abnormalities, pneumonia and a bullous skin disease known as pemphigus syphiliticus. [3]

Late[edit]
Late congenital syphilis is a subset of cases of congenital syphilis. By definition, it occurs in children at or greater than 2 years of
age who acquired the infection trans-placentally.
Symptoms include[4]

•blunted upper incisor teeth known as Hutchinson's teeth

•inflammation of the cornea known as interstitial keratitis
•deafness from auditory nerve disease
•frontal bossing (prominence of the brow ridge)
•saddle nose (collapse of the bony part of nose)
•hard palate defect
•swollen knees
•saber shins
•short maxillae
•protruding mandible
A frequently-found group of symptoms is Hutchinson's triad, which consists of Hutchinson's teeth (notched incisors), keratitis and
deafness and occurs in 63% of cases.[4]
Treatment (with penicillin) before the development of late symptoms is essential. [5]

pox virus and varicella zoster

transmission: vertical

Clinical symptoms:

1st and 2nd trimesters – developmental abnormalities (scars on the skin, failed development of limbs, small
eyes).
'third trimester - the disease may vary in severity: from mild to
severe generalized infection with high fever and a rash.

Diagnostics
• Virus isolation from skin lesions.
• Detection of specific IgM antibodies.

Treatment
• isolate the Newborn
• Acyclovir at 20 mg / kg i.v Every 8 hours.
• Specific immunoglobulin up to 72 hours of age (up to 3rd day of life)
BORRELLIOSIS, LYME DISEASE
caused by Borrelia burgdorferi.

Clinical symptoms

early on characterized by: respiratory disorders, hepaosplenomegaly, fever, and meningitis.

Diagnostics
Serological tests for specific antibodies: IgG and IgM.

Treatment
• Penicillin, cephalosporins

HIV

Routes of infection:
• contact with blood from the mother's genital tract
- placenta
• seropositive mother breastfeeding
Clinical symptoms
• Miscarriage, preterm delivery.
• Embropathy, microcephaly.
• Heart.
• Malnourished
• Chronic Diarrhea
• opportunistic infections.

Diagnostics

• In a child of the mother HIV + check bloods within 2 days.

• Determine the number of CD4 and CD8 lymphocytes.
• Virus culture.
• detection of viral antigen (HIV-1-p24) - spinal cord.
• Detection of viral RNA by PCR.
• Detection of anti-HN-1 antibodies in ELISA or Western test
reflects only that the mother's infected- the antibodies will be present up
until 6th-18th month of the child's life.

• The second test is HlV-RNA, p24Ag and viral culture should be performed
between 6-8. week of life.

Treatment
In the case of HIV+mother , its is recommened an anti-viral HAART therapy
(highly active antiretroviral therapy).
• Zydowudin (Retrovir) is given to the mother intravenously during labor
and the newborn right after delivery.
• The start of treatment depends on the viraemia in the mother of the 36th week of
pregnancy; in the case of viraemia, below the detection level, we use ZIDOVUDIN
(AZT, RETROVIR) and lamivudine (3TC); Continue treatment until the end of the 4th week of life.

in the first 12-24 hours of age give newborn vaccines against

Hepatitis B
• BCG vaccination is contraindicated
◦ in children of HIV + mothers. And only given once HIV is ruled out in neonate

• if moderate/ significat viremia in mother and neonate for the first 2 weeks add on a third drug luteinavirapine is used (Viramune).

• The method of termination of pregnancy also depends on the viral load in the mother at the 36th gestation week.

• Breastfeeding FORBIDDEN
• trimethoprim + sulfamctoxazole given until the first birthday as Prophylaxis of Pneumocystis carinii infection

LISTERIOSIS
Disease caused by Listeria monocytogenes

route of transmission in newborn:

-blood,
- perinatal

Clinical symptoms
• Symptoms in the neonatal period:
- sepsis,
- acute respiratory insufficiency
- hcpatspłenomcgalia,
- meningitis.

Diagnostics
• Bacteriological (culture) of blood, cerebrospinal fluid, secretions from the vagina, meconium.
• PCR testing.

Treatment :
Ampicillin with aminoglycoside.

Erythromycin is also effective and cotrimoxazole.

Part 2 pg 43/122

Odra (morbilli)- MEASLES

etiopathogenesis
• Infection with measles virus (DNA - Paramyxoviridae).
• Infect with a droplet, the source of the infection is a person who is ill.
• Period of infectivity 4 days before and 3 days after the onset of rash.
• incubation period- 9-11 days.

There are three stages: catarrhs, rash and healthy period.

On day 14- you start the rash period

Clinical symptoms
• catarrhs period (harbingers)

- fever up to 39 "C, dry cough, nothing in the nose, throat and larynx,
cleavage, conjunctivitis;
- Koplik spots (grey-white spots with red border at level of lower molars)- appear in 2 -3 rd day of the catarrhal period

gray-white spots with a red border locate on the bladder

of the oral cavity at the level of the lower molars and the
shafts are ahead of the rash by 1-2 days;

• Rash period:

- it lasts 3-4 days; fever up to 4o• c, deterioration of general condition

- small, vivid red spots, and lump clods, localized in back of the ears, on the hairline, quickly they cover the face and
limbs and limbs tend to merge;

• Healthy period
lasts several days; resolution of rash and physical
symptoms of viral infection, normalization of body temperature.
After spawning

COMPLICATIONS:
affects15% of patients; in patients over 10 years of age, the risk
increases two or three times.
• Frequently they will have pneumonia, bronchitis,
subglottic laryngitis, middle ear infection

less often it may lead to Guillain-Barrigo, paralysis and retrobulbar optic nerve

Third world countries occur: inflammation and corneal ulcer (due to vitamin A deficiency), diarrhea,
hone in myocardial infarction, secondary bacterial infections.
• Severe lymphocytic form of the disease.
• Benign encephalomyelitis (1: 1000 cases) - the most severe
complication, mortality 10-30%.
• Subacute sclerosing white brain essence (SSPE) - 4-10
years after measles dissemination (1: 1000 cases).
Laboratory diagnosis
From • a: e Leukopenia, no characteristic deviations in 'studies'.
diagnostics.

Treatment
• Symptomatic.

Prevention

Vaccination according to the vaccination schedule (Priorix, M! Vffi).

• Passive immunity:

- gammaglobulin 0.25 ml / kg me. (max 15m) up to 5 days after contact

(in infants, children with leukemia, and in children during treatment
munosupressive, in pregnant women);

- at six months <6 months (if the mother was vaccinated)

and had measles) it is not advisable to administer gamma globulins after

position;

- children infected with HIV or those with Al DS are given siQ

0.5 ml! Kg me. after exposure, even if they were vaccinated.

*polish site:
The rash period begins about the 14th day after infection, after a period of catarrh. He is accompanied by a high fever. Behind the ears on the face and neck appears a
patchy rash, sometimes papulous, which in the second day goes down to the body, and in the third includes limbs. It has a tendency to merge. During the recovery period,
the fever drops, the rash turns brown and disappears in the order in which it occurred. Discoloration after a rash and gentle exfoliation of the epidermis last about 2
weeks. Measles are diagnosed on the basis of clinical, serological and virological findings.

Treatment of measles is only symptomatic, it consists in reducing fever and irrigation. The survival of measles leaves durable immunity.

What are the complications of measles?

There are complications in the course of measles: pneumonia, bronchitis, larynx, middle ear, diarrhea. Neurological complications (meningitis and

encephalitis) are very serious. A distant complication of measles is subacute sclerosing encephalitis, which is an incurable disease. It occurs after a

few or a dozen years from getting measles. More often in people who have had measles before the age of 2.
Treatment of measles complications is carried out in the hospital. Depending on the type of complications, antibiotics, steroidal and anticonvulsant

preparations are used.

Vaccination is the most important thing in preventing measles. Thanks to commonly conducted protective vaccinations, the number of cases has

clearly decreased. Currently, only about 100 cases of measles are registered in Poland every year.