congenital and neonatal infections

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Congenital and Neonatal Infections Done by: A M A L… S A R A H… A Y A T Presented to: Dr. A yh a m A bul a il a

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New born s are particularly susceptible to certain diseases, much more so than older children and adults. Their new immune systems aren't adequately developed to fight the bacteria, viruses, and parasites that cause these infections. As a result, when newborns get sick >>> they may need to spend time in the hospital — or even the neonatal intensive care unit (NICU) — to recover.

Cont…:

Cont… It's more likely that babies will be born with an infection if their mothers become infected for the first time with a particular germ while pregnant. However, transmission to the baby doesn't always occur, so many babies born to mothers with these infections don't have the infection themselves. Other newborns may not initially show signs of disease, but may later exhibit its effects .

Signs to Look for…:

Signs to Look for… if your new baby shows any of these possible signs of infection >>> Call your child's doctor : poor feeding breathing difficulty listlessness decreased or elevated temperature unusual skin rash or change in skin color persistent crying unusual irritability

Cont…:

Cont… A marked change in a baby's behavior, such as suddenly sleeping all the time or not sleeping much at all, can also be an indication that something isn't right. These signs are of even greater concern if the baby is less than 2 months old.

Bacterial infections … …SARAH…:

Bacterial infections … …SARAH…

Meningitis… What is it?:

Meningitis… What is it? >>> is an inflammation of the membranes surrounding the brain and spinal cord. Symptoms of infection in newborns aren't very specific and may include persistent crying, irritability, sleeping more than usual, lethargy, refusing to take the breast or bottle, low or unstable body temperature, jaundice, pallor, breathing problems, rashes, vomiting, or diarrhea. As the disease progresses, babies' fontanels, or soft spots, may begin to bulge .

Sepsis… What is it?:

Sepsis… What is it? >>> is a serious infection that involves the spread of germs throughout the body's blood and tissues. infectious agents are acquired during birth. As with meningitis, the symptoms of sepsis are not specific and vary from child to child. A lower heart rate, breathing problems, jaundice, trouble feeding, low or unstable body temperature, lethargy, or extreme fussiness can all be signs of an infection.

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The following are risk factors for neonatal sepsis: Preterm infants ≤37 weeks gestation Maternal fever >100.4oF (especially when >101 oF) Rupture of membranes >18 hours Colonization with GBS in maternal vaginal or anorectal cultures , GBS bacteriuria Previous delivery of infant with invasive GBS disease Maternal age <20 years Maternal intra-amniotic infection (IAI) Maternal tachycardia (HR>90/minute) Fetal tachycardia (HR>170/minute) Maternal leukocytosis (WBC>15,000) Foul-smelling amniotic fluid

I’m strong when I’m on your shoulders… you raise me up to more than I can be…:

I’m strong when I’m on your shoulders… you raise me up to more than I can be…

Group B Streptococcal Disease (GBS):

Group B Streptococcal Disease (GBS) Some of the most common infections are sepsis, pneumonia, and meningitis. Babies usually get the bacteria from their mothers during birth where they can easily pass to the newborn if the mother hasn’t been treated with antibiotics. Babies with GBS often show symptoms of infection within the first week of life, although some develop symptoms weeks or months later. Depending on the infection, the symptoms might include trouble breathing or feeding, a high temperature, listlessness, or unusual crankiness.

Listeriosis…:

Listeriosis… Infection with Listeria monocytogenes can lead to pneumonia, sepsis, and meningitis in newborns. Babies can acquire bacteria from their mothers if the mother contracts listeriosis while pregnant. In severe cases, listeriosis may lead to premature delivery or even Babies born with listeriosis may show signs of infection similar to those of GBS.

E. Coli…:

E. Coli… Escherichia coli can lead to: urinary tract infections, sepsis, meningitis, and pneumonia. Most newborns who become ill from E. coli infection have particularly fragile immune systems that make them particularly vulnerable to getting sick. As with other bacterial infections, the symptoms will depend on the kind of infection that develops from E. coli, but fever, unusual fussiness, listlessness, or lack of interest in feeding are common.

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الحمد لله الذي عافانا

Conjunctivitis… What is it?:

Conjunctivitis… What is it? Some newborns develop an inflammation of the eye's covering membranes (or conjunctiva), known as conjunctivitis or pinkeye it appears as redness and swelling in the eye , usually accompanied by a discharge . Both bacterial and viral infections can cause conjunctivitis in newborns.

Cont…:

Cont… It’s caused by intrapartum infection by agents including: Neisseria gonnorhoeae Chlamydia trachomatis Staphylococcus adenoviruses

Omphalitis ... What is it?:

Omphalitis ... What is it? >>> is infection of the umbilical stump , and may spread via the umbilical vessels to the abdominal viscera or can develop into septicemia Staph. aureus Gram – bacilli The stump should be dusted with antiseptic powder until it falls off in order to prevent it.

Scalded skin syndrome… What is it?:

Scalded skin syndrome… What is it? >>> extensive exfoliation of skin caused by staph. aureus

Congenital syphilis… What is it?:

Congenital syphilis… What is it? >>> is a multisystem infection caused by Treponema pallidum which is passed from mother to child during fetal development or at birth. Nearly half of all children infected with syphilis while they are in the womb die shortly before or after birth. Despite the fact that this disease can be cured with antibiotics if caught early, rising rates of syphilis among pregnant women in the United States have increased the number of infants born with congenital syphilis.

Cont…:

Cont… Early signs are characteristic skin lesions, lymphadenopathy, hepatosplenomegaly, failure to thrive, blood-stained nasal discharge, meningitis, choroiditis, hydrocephalus, seizures, intellectual disability, osteochondritis, and pseudoparalysis (Parrot's atrophy of newborn). Later signs are gummatous ulcers, periosteal lesions, optic atrophy, interstitial keratitis, sensorineural deafness, and dental deformities . Diagnosis is clinical, confirmed by microscopy or serology. Treatment is penicillin.

Neonatal Tetanus…:

Neonatal Tetanus… Most infants who get the disease die. >>> is particularly common in rural areas where most deliveries are at home without adequate sterile procedures. Prevention: Toxoid as DTP, DT, TT or Td - at least three primary doses given by the intramuscular route

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Goodbye to you my trusted friend…

Now who’s next ??? …AYAT… viral infections:

Now who’s next ??? … AYAT … viral infections

Cytomegalovirus…:

Cytomegalovirus… Primary CMV infection in pregnancy : 1 – 4% Fetal infection rate : 40% Recurrence, fetal infection rate: 1% Transmission: transplacental, birth canal & breast feeding. Abortion

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Microcephaly thrombocytopenia hepatitis jaundice petechiae Intrauterine growth retardation

Rubella…:

Rubella… Transplacental… Miscarriage Now rare in developed countries with rubella vaccination programmes

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Congenital rubella syndrome ( CRS ) Intrauterine growth retardation Sensorineural deafness Hepatosplenomegaly Cataracts and myocarditis . Fetal Complications Onset of maternal infection Congenital rubella syndrome (>90%) <12 weeks Sensorineural deafness (20%) 12-18 weeks Rare >18 weeks

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"blueberry muffin" skin lesions

Parvovirus B19…:

Parvovirus B19… Transmitted Transplacental Erythema infectiosum Miscarriage Fetal anemia Hydrops fetalis Myocarditis & Intrauterine fetal death

Herpes simplex virus…:

Herpes simplex virus… 90% : the birth canal 5% : ' congenital ' HSV infection 5% : post- natally acquired infection Primary Herpes infection in the late third trimester is far more dangerous than earlier infection Initial symptoms of this disease usually present during the first 4 weeks of life.

Cont …:

Cont … localized skin, eye, or mouth disease central nervous system (CNS) disease disseminated disease that involves multiple organs.

Varicella-zoster virus…:

Varicella-zoster virus … Transplacental & Perinataly. If infection near term, may lead to postnatal infection Infection before 20 weeks : abortion, limb hypoplasia , skin scarring, IUGR, neurological abnormality and Hydrops fetalis.

Human immunodeficiency virus…:

Human immunodeficiency virus… Transmission: transplacental, birth canal & breast feeding . 2.4 million HIV-infected women deliver children every year worldwide .

Human papillomavirus…:

Human papillomavirus… Perinataly Warts in the mouth and in the respiratory tract.

Micro lab baby …:

Micro lab baby …

Hepatitis B…:

Hepatitis B… Perinataly & breastfeeding . Congenital infection is more likely to chronic infection. Transmission rates can be significantly reduced by active immunization with hepatitis B vaccine combined with passive immunization using hepatitis B immunoglobulin within 12 hours of birth.

Hepatitis C…:

Hepatitis C … HCV RNA-negative pregnant women : 1-3% HCV RNA-positive women: 4-6% HCV & HIV positive: 23% . The use of a scalp electrode and duration of membrane rupture beyond 6 hours may increase risk of transmission.

Measles virus…:

Measles virus… Neonates born to mothers with active measles virus infection are at risk of developing neonatal measles , but no congenital syndrome has been described. Not teratogenic , spontaneous abortion, premature labor, pneumonitis predominating, and low birth weight .

Lymphocytic choriomeningitis virus…:

Lymphocytic choriomeningitis virus… chorioretinitis hydrocephalus mental retardation, and/or visual impairment intrauterine death is possible.

Enterovirus…:

Enterovirus… Enterovirus infections are not believed to cross the placenta and cause fetal disease. However, some studies have linked coxsackievirus and echovirus to miscarriage, neurodevelopmental delay, myocarditis, and cortical necrosis. One study linked the presence of coxsackievirus in the third trimester with respiratory failure and global cognitive defects .

H1N1…:

H1N1… Same risk like any other viral infection Risk of abortion , preterm birth & pnuemonia . Infants risk of neural tube defects , seizers , encephalopathy , cerebral palsy & neonatal death . Chemoprophylaxis :( Tami flu ) for 10 days

TORCH test…:

TORCH test… Blood test measures the presence of antibodies and their level of concentration in the blood. belongs to a category of blood tests called infectious-disease antibody titer tests . Measures the levels of an infant's antibodies against five groups of chronic infections: T oxoplasmosis , O ther infections , R ubella , C ytomegalovirus (CMV) , and H erpes simplex virus (HSV) . The " other infections " usually include: syphilis, hepatitis B,coxsackie virus, Epstein-Barr virus, varicella-zoster virus, and human parvovirus.

When is it ordered?... :

When is it ordered?... The test is ordered when a pregnant woman is suspected of having any of the TORCH infections. The test may be ordered on the newborn when the infant shows any signs suggestive of these infections, such as: exceptionally small size relative to the gestational age, deafness, mental retardation, seizures, heart defects, cataracts, enlarged liver or spleen, low platelet level, or jaundice.

What does the test result mean?...:

What does the test result mean?... Presence of IgM antibodies in the newborn indicates high likelihood of infection with that organism. Presence of IgG and absence of IgM antibody in the infant may reflect passive transfer of maternal antibody to the baby and does not indicate active infection in the baby.

No, no, no … Always, there’s Hope…:

No, no, no … Always, there’s H o p e …

Finally, continue with …AMAL… fungal and parasitic infections:

Finally, continue with … AMAL … fungal and parasitic infections

Candidiasis…:

Candidiasis… An overgrowth of the common yeast candida . In newborns, it usually shows up as diaper rash , but babies can also develop oral thrush in the mouth and throat. It causes cracks in the corners of the mouth and white patches on the tongue, palate, lips, and insides of the cheeks . Newborns who get thrush have often picked up the fungus from the mother's vagina during delivery or during breastfeeding .

How is it diagnosed and treated…:

How is it diagnosed and treated… The doctor will take a swab of one of the patches in the mouth and examine it for signs of the fungus. In most cases, this isn't necessary and treatment is started based on the appearance of the mouth lesions alone. Thrush can be treated with liquid antifungal medicine .

Ptyrosporum folliculitis…:

Ptyrosporum folliculitis… Pityrosporum yeasts ) Malassezia furfur ) are the cause of pityriasis versiculor, very rare cause of folliculitis in neonates. Cutaneous lesions consist of follicular papules and sparse pustules on the face and scalp. The diagnosis is based on a positive KOH and culture of pustular contents. Treatment is achieved with topical imidazole derivatives such as miconazole , clotrimazole, or ketoconazole cream .

Neonatal Sepsis …:

Neonatal Sepsis … C albicans Candida lusitaniae Candida parapsilosis Candida tropicalis Trichosporon beigelii Torulopsis species

Infants with neonatal sepsis or infection may exhibit some of these symptoms::

Infants with neonatal sepsis or infection may exhibit some of these symptoms : apnea shock diarrhea seizures jaundice vomiting cyanosis irritability skin rashes nasal flaring

The sleeping princess…:

The sleeping princess…

Toxoplasmosis …:

Toxoplasmosis … Toxoplasmosis is caused by the parasite Toxoplasma gondii , which is commonly found in cats and can be passed to humans in cat feces. Handling soiled cat litter is the typical way that the disease is transmitted to humans, but the parasite also may be present in raw or undercooked meat .

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Women who are first infected with the parasite shortly before they become pregnant or when they are pregnant can pass the organism to the fetus , leading to congenital toxoplasmosis. the symptoms of this condition include jaundice, rash, fever, anemia, inflammation of the retina of the eye, intracranial calcifications and an enlarged spleen and liver . A baby with congenital toxoplasmosis may be blind or have learning and motor (movement) disabilities and other central nervous system problems. The problems associated with congenital toxoplasmosis may be present at birth or appear as the child develops .

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Toxoplasma in retina Intracranial calcification

Testing…:

Testing… Toxoplasma: Specific IgM antibody in blood (if IgG positive), tissue culture, PCR and follow-up serology may be required. Avoiding contact with cat feces and not eating or handling raw meat can reduce the risk of contracting toxoplasmosis

LOL ^_^:

LOL ^_^

Scabies…:

Scabies… Scabies is a contagious disorder caused by Sarcoptes scabiei , a parasitic mite, which invades the stratum corneum . Vesicles are common in neonates, and there is a tendency for pustule formation early in the course of the infestation. Irritability, poor feeding, and failure to gain weight are also quite characteristic. A careful history and examination of the baby's caretakers will frequently disclose a history or pruritus and/or typical scabies lesions

Trichomonas vaginalis …:

Trichomonas vaginalis … T . vaginalis is a highly contagious protozoan most commonly transmitted through sexual intercourse . Neonatal infection with T. vaginalis is infrequently reported, but has been noted to cause urinary tract infections and vaginitis in infants as premature as 28 weeks' gestation. In addition, infants with T. vaginalis cultured from nasopharyngeal secretions have been reported to present with significant respiratory distress The patient was treated with metronidazole

Trypanosoma cruzi…:

Trypanosoma cruzi… The symptomatic cases ( so-called congenital Chagas disease , whereas congenital T. cruzi infection refers to asymptomatic as well as symptomatic cases) are frequently premature , displaying low birth weight and hepatosplenomegaly . Symptoms of acute respiratory distress (probably related to prematurity) . Meningoencephalitis and myocarditis are more frequently observed in cases of co-infection with HIV. There is no specific clinical marker of congenital Chagas disease

What a messed life is waiting there??!! No, I'm gonna make change…:

What a messed life is waiting there ? ? ! ! No, I'm gonna make change…

Complications of Neonatal Infections…:

Complications of Neonatal Infections… Neonatal infections that aren't treated promptly or that spread can have serious consequences. Because babies' bodies and organs are undergoing rapid development, any interruption in that process can lead to complications, including growth, developmental, neurological, cardiac, respiratory, and sensory problems . In some severe cases, neonatal infections can even be fatal.

Cont…:

Cont… With their fragile new immune systems, babies aren't well equipped to deal with infection. Premature or otherwise immunocompromised babies are at an even greater risk of developing a critical disease from a bacterium or virus that might cause a simple illness in an older child. An early diagnosis, swift treatment, and close monitoring and care give a baby the best chance of overcoming the infection.

Can Neonatal Infections Be Prevented???:

Can Neonatal Infections Be Prevented??? If a pregnant woman is diagnosed with one of these infections, or if she is considered at risk of infection, preventive measures can lower the probability that she will pass it to her baby. Because many infections can be treated with medicine given to the mother while she's pregnant, maternal testing is extremely useful. In many cases, a quick blood or fluid test can determine if a pregnant woman should receive treatment. For a woman with listeriosis, a course of antibiotics usually prevents transmission of the bacterium to the fetus. Women who are HIV positive are advised to take antiretroviral medication during pregnancy to lower the risk that their babies will contract HIV infection.

Cont…:

Cont… Other neonatal infections are best prevented through steps that keep expectant mothers from developing the infection in the first place by: making sure they've been immunized against rubella and chickenpox infection before trying to become pregnant thoroughly washing and cooking food, regularly washing hands, and avoiding all contact with cat and other animal feces to lower the risk of contracting bacteria and parasites that lead to infections such as listeriosis and toxoplasmosis practicing safe sex to avoid sexually transmitted diseases (STDs) that can lead to congenital infections

Cont…:

Cont… Many doctors recommend that an expectant mother have a simple swab test late in pregnancy to check whether she's carrying GBS. If she is, she will receive intravenous (IV) antibiotics during delivery to lower the risk of transmitting the bacteria to her baby. Doctors also routinely put antibiotic drops or ointment in newborns' eyes to prevent conjunctivitis caused by gonorrhea bacteria.

Thank You…:

Thank You…