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Cong_Infection_Lecture - PATRICK DUFF M.D UNIVERSITY OF...

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PATRICK DUFF, M.D. UNIVERSITY OF FLORIDA
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CONGENITAL INFECTIONS OVERVIEW Rubella CMV Parvovirus Toxoplasmosis
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CONGENITAL INFECTIONS OVERVIEW Epidemiology and pathophysiology A Manifestations of congenital infection A Diagnosis of congenital infection A Prevention and treatment
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CONGENITAL INFECTIONS KEY QUESTIONS Manifestations of congenital infection Most valuable diagnostic tests Prevention and treatment
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CONGENITAL INFECTIONS “BIG PICTURE” Maternal infection in the first half of pregnancy, particularly the first trimester, poses the greatest risk to the fetus
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RUBELLA EPIDEMIOLOGY RNA virus Only a single serotype Occurs primarily in children and adolescents Most highly teratogenic of essentially all organisms
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RUBELLA EPIDEMIOLOGY With licensure of an effective vaccine in 1969, the frequency of infection has declined by 99 % Accordingly, congenital infection is extremely rare
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RUBELLA PATHOPHYSIOLOGY Transmission is by respiratory droplets A Respiratory tract -->cervical lymph nodes-->hematogenous dissemination A Incubation period is 2 to 3 weeks
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RUBELLA CLINICAL MANIFESTATIONS Malaise Headache Myalgias and arthralgias
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RUBELLA CLINICAL MANIFESTATIONS Post-auricular adenopathy Conjunctivitis NON-PRURITIC, ERYTHEMATOUS, MACULOPAPULAR RASH
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RISK OF CONGENITAL RUBELLA 0 5 10 15 20 25 30 35 40 45 50 1-4 wks 5-8 wks 9-12 wks > 12 wks % Time of Maternal Infection
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MANIFESTATIONS OF CONGENITAL  RUBELLA 0 10 20 30 40 50 60 70 80 Deafness Eye CNS Cardiac %
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CONSEQUENCES OF CONGENITAL  RUBELLA Only 25 % attend mainstream schools Estimated lifetime cost of caring for an affected child - $300,000
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