torch infections

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torch infections torch infections ashley m. maranich, md cpt/usa/mc pediatric infectious disease fellow torch infections t=toxoplasmosis o=other (syphilis) r=rubella c=cytomegalovirus (cmv) h=herpes simplex (hsv) you are taking care of a term newborn male with birth weight/length 4 times maternal test positive igm antibody diagnosing congenital syphilis igg can represent maternal antibody, not infant infection this is very intricate and often confusing consult your redbook (or peds id folks) when faced with this situation treatment penicillin g is the drug of choice for all syphilis infections maternal treatment during pregnancy very effective (overall 98% success) treat newborn if: they meet cdc diagnostic criteria mom was treated 80% develop long term complications hearing loss, vision impairment, developmental delay ventriculomegaly and calcifications of congenital cmv diagnosis maternal igg shows only past infection infection common – this is useless viral isolation from urine or saliva in 1st 3weeks of life afterwards may represent post-natal …
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(sem) cns disease disseminated disease (present earliest) initial manifestations very nonspecific with skin lesions not necessarily present presentations of congenital hsv diagnosis culture of maternal lesions if present at delivery cultures in infant: skin lesions, oro/nasopharynx, eyes, urine, blood, rectum/stool, csf csf pcr serologies again not helpful given high prevalence of hsv antibodies in population treatment high dose acyclovir 60mg/kg/day divided q8hrs x21days for disseminated, cns disease x14days for sem ocular involvement requires topical therapy as well which torch infection presents with… snuffles? syphilis chorioretinitis, hydrocephalus, and intracranial calcifications? toxo blueberry muffin lesions? rubella periventricular calcifications? cmv no symptoms? all of them which torch infections can absolutely be prevented? rubella syphilis when are torch titers helpful in diagnosing congenital infection? never! questions?
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torch infections torch infections ashley m. maranich, md cpt/usa/mc pediatric infectious disease fellow torch infections t=toxoplasmosis o=other (syphilis) r=rubella c=cytomegalovirus (cmv) h=herpes simplex (hsv) you are taking care of a term newborn male with birth weight/length 4 times maternal test positive igm antibody diagnosing congenital syphilis igg can represent maternal antibody, not infant infection this is very intricate and often confusing consult your redbook (or peds id folks) when faced with this situation treatment penicillin g is the drug of choice for all syphilis infections maternal treatment during pregnancy very effective (overall 98% success) treat newborn if: they meet cdc diagnostic criteria mom was treated 80% develop long term complications hearing loss, vision i...

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