Symptomatic neonatal CNS involvement is most commonly seen in which group of congenital intrauterine infection?
CMV and toxoplasmosis
Rubella and toxoplasmosis
Rubella and HSV
CMV and syphilis
c. Rubella and HSV(Ref: Nelson's 20/e p 1548-1551)Symptomatic CNS infections in neonatal period are most commonly seen in HSV (75-100%) f/b Rubella (30-60%);CMV, toxoplasma, and syphillis become symptomatic in less than 10%-15% of cases.Characteristic clinical features of Intrauterine InfectionsInfectionIUGRHSMBleedingEye signsCNS featuresOthersConge-nital CMV disease60-70%2/3rd of patients"Blue berry muffinspots""Cottage cheese with Ketchup" choriore-tinitis,sparing of macula, optic atrophyMicro-cephaly, periven-tricular calcifi-cation,mental retardationAnemia, sensori-neural deafness, pneumoniaConge-nitalRubella60%60-70%50-60%Cataracts, glaucoma, corneal opacity,salt& pepper choriore-tinitisMeningo-encephalitis, deafness, mental retardationCardiac defects like PDA, PS, VSD; bone lesionsConge-nital Toxopla-smosis20-30%40-50%30-40%Choriore-tinitis with macular involve-ment, optic atrophy, cataract, uveitisHydroc-ephalus, microce-phaly, Diffuse cerebral calcifi-cationStrabismus, nystagmus, visual impairmentConge-nitalsyphilisUncom-mon30-40%Uncom-monInterstitial Keratitis, Choriore-tinitisMeningo-encepha-litisRashes, snuffles,periosteitis, chondritis, deafnessConge-nitalVaricellaLBWcommonUncom-monUncom-monChoriore-tinitis, microph-thalmia, and cataractsMicroce-phaly, cortical atrophy, seizures, ID, neurogenic bladder, swallowing dysfunctioncicatricial skin scarring in a zoster-like distrib-ution; limb hypoplasia; hydron-ephrosisHerpessimplexNone50%Uncom-monKeratitis, Conjun-ctivitis, Choriore-tinitis, CataractsMeningo-encephalitis, micro-cephaly, Intracranial CalcificationVesicles, Pneumonia, Hepatitis, mucocu-taneous lesions
General Considerations - Infectious Diseases