Page 226 - First Aid for the USMLE Step 1 2020, Thirtieth edition [MedicalBooksVN.com]_Neat

182 SEcTioN ii Microbiology ` microbiology—systems Microbiology ` microbiology—systems

TORCH infections Microbes that may pass from mother to fetus. Transmission is transplacental in most cases, or via
delivery (especially HSV-2). Nonspecific signs common to many ToRCHHeS infections include
hepatosplenomegaly, jaundice, thrombocytopenia, and growth retardation.
Other important infectious agents include Streptococcus agalactiae (group B streptococci), E coli,
and Listeria monocytogenes—all causes of meningitis in neonates. Parvovirus B19 causes hydrops
fetalis.

ageNt moDes oF materNal traNsmissioN materNal maNiFestatioNs NeoNatal maNiFestatioNs
Toxoplasma gondii Cat feces or ingestion of Usually asymptomatic; Classic triad: chorioretinitis,
undercooked meat lymphadenopathy (rarely) hydrocephalus, and
intracranial calcifications,
+/− “blueberry muffin” rash A
Rubella Respiratory droplets Rash, lymphadenopathy, Classic triad: abnormalities
polyarthritis, polyarthralgia of eye (cataracts B ) and ear
(deafness) and congenital heart
disease (PDA); +/– “blueberry
muffin” rash. “I (eye) ♥ ruby
(rubella) earrings”
Cytomegalovirus Sexual contact, organ Usually asymptomatic; Hearing loss, seizures, petechial
transplants mononucleosis-like illness rash, “blueberry muffin” rash,
chorioretinitis, periventricular
calcifications C
HIV Sexual contact, needlestick Variable presentation depending Recurrent infections, chronic
on CD4+ cell count diarrhea
Herpes simplex virus-2 Skin or mucous membrane Usually asymptomatic; herpetic Meningoencephalitis, herpetic
contact (vesicular) lesions (vesicular) lesions
Syphilis Sexual contact Chancre (1°) and disseminated Often results in stillbirth,
rash (2°) are the two stages hydrops fetalis; if child
likely to result in fetal infection survives, presents with facial
abnormalities (eg, notched
teeth, saddle nose, short
maxilla), saber shins, CN VIII
deafness
A B C

FAS1_2019_03-Microbiology.indd 182 11/14/19 12:22 PM