Sandbox: Reddy

Diseases	Causative Organism	Transmission	Timing of Infection	Clinical Symptoms in the Mother	Clinical Manifestations in the newborn	Classification	Diagnosis	Treatment
Congenital Syphilis	Treponema Pallidum	Vertical	16th to 28th week	Based on the stage of Syphilis infection	Low birth weight Non-immune Hydrops Maculopapular or Vesicobullous rash on the palms and soles Interstitial Keratitis Rhinitis	Early congenital syphilis Late congnenital syphilis Stigmata	Detection of IgM aganist T.pallidum in blood collected in chordocentesis Amniotic fluid PCR for T. pallidum DNA Antenatal Ultrasound	Aqueous crystalline penicillin G 100,000-150,000 U/kg/day, administered as 50,000 U/kg/dose IV q12h during the first 7 days of life and q8h thereafter for a total of 10 days
Congenital Toxoplasmosis	Toxoplama gondii	Vertical	Third Trimester	Majority : Asymptomatic Few patients can have flu like symptoms	Low birth weight Chorioretinitis Microcephaly Intracranial calcification Spasticities and Paresis Sensorineural deafness	None	Amniotic fluid PCR for T.gondii DNA Detection of parasite in Amniotic fluid Serology	Infected mothers without fetal infection : Spiramycin Infected mothers with established fetal infection : Pyrimethamine, sulfadiazine, and folinic acid
Congenital Varicella Syndrome	Varicella Zoster virus	Vertical	13 to 20th week	Vesicular skin rash Fever	Cicatrical skin lesions Limb hypoplasia Microcephaly Autonomic instability Chorioretinitis Microphalmia and anisocoria	None	Antenatal Ultrasound Fetal MRI Amniotic fluid PCR for VZV DNA	Termination of pregnancy with severe defects No definitive treatment Preconceptional vaccination
Congenital CMV	CMV Virus	Vertical	First trimester	Fever Cervical lymphadenopathy	SGA Microcephaly Sensorineural hearing loss Cataracts Petechiae and purpura Jaundice Poor sucking when feeding Hypotonia	Symptomatic Asymptomatic	Antenatal Ultrasound Amniotic Fluid PCR for CMV DNA CT brain	IV Ganciclovir Oral Valganciclovir
Congenital Rubella Syndrome	Rubella	Vertical	8 to 10th week	Asymptomatic Maculopapular rash starting on the face and spreads caudally Polyarthalgia	Low birth weight VSD and PDA Cataracts, glacoma, retinopathy Sensorineural hearing loss Microcephaly Encephalitis	None	Direct isolation of the virus Viral nucleic acid quantification Detection of IgM/ IgA antibodies in fetal blood Serological Testing	Termination of pregnancy: If infection diagnosed before 18weeks of pregnancy No definitive Treatment
Neonatal Herpes Simplex	HSV-1 and HSV-2	Direct Contact	At term	Genital or Orolabial herpes	Vesicular skin lesions Oral Ulcers Chorioretinitis and conjunctival erythema Encephalitis DIC Pneumonitis	Skin, eye, mouth disease (SEM) CNS Disease Disseminated Disease	Surface Cultures CNS fluid analysis Elevated Alanine Transaminase	SEM : IV Acyclovir for 10 days Disseminated and CNS disease: IV Acyclovir for 14 to 21 days