Category Archives: Infection

Tip 48: herpes simplex virus (HSV) infection

There are three main presentations of neonatal HSV: 1. Disseminated disease involves lungs, liver, adrenal glands, skin, eyes, and brain 2. Skin, eyes and/or mouth (SEM) disease 3. Central nervous system disease. Symptoms are generally non-specific and only 2/3 have … Continue reading

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Tip 46: meningitis

The incidence of neonatal meningitis is 2-3/10,000 births. The most common organisms are: GBS Gram negative bacilli (E. coli, Haemophilus influenzae) Streptococcus pneumoniae Listeria is less common than 20 years ago. Long term complications include hydrocephalus, seizures, hemiparesis, deafness & … Continue reading

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Tip 45: Group B Streptococcus (GBS)

~25% of women carry GBS vaginally. ~90% of babies with GBS infection present within 24 hours of birth. It typically presents with sepsis (69%), pneumonia (26%), respiratory distress (13%), and meningitis (11%). References: Heath PT, Jardine LA. Neonatal infections: group B … Continue reading

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Tip 33b: congenital CMV

>90% infants with infection are asymptomatic but can still develop sensorineural hearing loss. Other symptoms/signs are: IUGR, microcephaly,  thrombocytopenia, jaundice, hepatitis, pneumonitis, periventricular calcification, chorioretinitis and cataracts. Reference: Rennie & Roberton’s Textbook of Neonatology, 5th Ed, 2005. London: Churchill.

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Tip 33a: congenital cytomegalovirus (CMV)

In the UK, 50% women in antenatal clinics are seropositive for CMV. Incidence of congenital CMV infection is ~3 in 1,000 live births. Placental transmission rates are ~40% during primary infection and 1% for reactivated infection. The earlier the gestation … Continue reading

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Tip 24: congenital toxoplasmosis

Severity of infection is worst in the first trimester with intracranial calcification and ventriculomegaly being poor prognostic signs. Mostly though, prognosis is good, especially with antiparasitic treatment following fetal diagnosis on amniocentesis. Reference: Rennie & Roberton’s Textbook of Neonatology, 5th Ed, … Continue reading

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Tip 19b: congenital rubella syndrome

In the presence of maternal infection, transmission is ~50% in the first month of pregnancy, reducing to 10% in the third month of pregnancy. Reference: Rennie & Roberton’s Textbook of Neonatology, 5th Ed, 2005. London: Churchill.

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