Image Based Question-67051

Identify the fetal infection derived from mother:

A. Congenital Toxoplasmosis

B. Congenital Rubella

C. Congenital Syphillis

D. Congenital CMV

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Correct Answer » D Explanation

Ans:D. Congenital CMV.

Periventricular calcifications are seen in the MRI image suggestive of congenital CMV.

TORCH infection.

• They are a group of congenitally acquired infections that are acquired by the mother and passed either transplacentally or during the birth process.

Toxoplasmosis:

• Causative Organism – Toxoplasma gondii
• Clinical Manifestations
• First Trimester – often results in death
• Second Trimester – classic triad

1. Hydrocephalus
2. Intracranial calcifications
3. Chorioretinitis

• Third Trimester – often asymptomatic at birth

• Symptoms may also include fever, IUGR, microcephaly, seizure, hearing loss, maculopapular rash, jaundice, hepatosplenomegaly, anemia, and lymphadenopathy.

Treatment

• Pyrimethamine , plus

• Sulfadiazine , plus Leucovorin after pyrimethamine therapy.

• Glucocorticoids when active chorioretinitis threatens vision.

Syphilis

• Causative Organism – Treponema pallidum

• Clinical Manifestations

• Majority are symptomatic at birth

• Early Congenital Syphilis (symptoms at 1-2 months of age)

• Maculopapular rash, “snuffles,” maculopapular rash, lymphadenopathy, hepatomegaly, thrombocytopenia, anemia, meningitis, chorioretinitis, osteochondritis

• Late congenital Syphilis (symptoms after 2 years of age)

1. Hutchinson Teeth
2. Mulberry Molars
3. Perforated hard palate
4. Rhagades (cracks or fissures in the skin around the mouth)
5. Saber Shins
6. Sensorineural hearing loss (CN VIII)
7. Interstitial Keratitis
8. Saddle Nose

Treatment :Penicillin

Rubella

• Causative Organism – Togavirus

• Clinical Manifestations

• “Blueberry Muffin” rash due to extramedullary hematopoiesis

• Cataracts

• “Salt and Pepper” retinopathy

• Radiolucent bone disease (long bones)

• IUGR, glaucoma, hearing loss, pulmonic stenosis, patent ductus arteriosus, lymphadenopathy, jaundice, hepatosplenomegaly, thrombocytopenia, interstitial pneumonitis, diabetes mellitus

Treatment:Supportive Care.

Cytomegalovirus

• Causative Organism – Human herpesvirus 5

• Clinical Manifestations

• Majority are asymptomatic at birth

• Periventricular calcifications

• IUGR, developmental delay, microcephaly, sensorineural hearing loss, retinitis, jaundice, hepatosplenomegaly, thrombocytopenia, hypotonia, lethargy, poor suck.

• Treatment:gancyclovir can improve hearing loss and neurodevelopmental outcomes.

Herpes Simplex Virus

• Causative Organism – Human herpesvirus 1 & 2

• SEM disease (Localized to skin, eyes, and mucosal)

• Vesicular lesions on an erythematous base.

• CNS disease.

• Disseminated disease

• Multiple organ involvement (CNS, skin, eye, mouth, lung, liver, adrenal glands)

Treatment

• Acyclovir