Infections in Neonates

Infections in Neonates

Multiple Choice

Determining the time of acquisition of an infection in a newborn can help determine the most likely causes. Which of the following statements regarding acquisition of infections is true?

• CMV and toxomplasmosis are usually acquired congenitally, HSV is usually acquired perinatally, and TB is usually acquired in the neonatal period

• Toxoplasmosis and HIV infection are usually acquired congenitally, CMV is usually acquired perinatally, and syphillis is usually acquired in the neonatal period

• HIV and parvovirus are usually acquired congenitally, rubella is usually acquired perinatally, and Zika virus is usually acquired in the neonatal period

• Rubella and Zika are usually acquired congenitally, Hepatitis B is usually acquired perinatally, and LCMV is usually acquired in the neonatal period

Multiple Choice

During a physical exam, a 4-day old male infant is noted to have evidence of intrauterine growth restriction, sensorineural deafness and congenital cataracts. His mother received no prenatal care and immigrated to the United States from Ethiopia 2 weeks prior to delivery. Which of the following best describes the murmur most likely to be heard in this infant?

• A continuous murmur heard best at the left infraclavicular area, which radiates to the back

• A systolic ejection murmur heard best at the right 2nd intercostal space, which radiates into the neck

• A short systolic murmur along the left sternal border in the 3rd and 4th interspaces associated with diminished femoral pulses

• A systolic ejection murmur in the region of the right ventricular outflow tract associated with a fixed split S2

• A pansystolic murmur heard best at the lower left sternal border

Multiple Choice

A term female infant is born with diffuse edema of the skin as well as ascites and pleural and pericardial effusions. The mother is known to be Rh-positive. You explain to the parents that there are many noninfectious causes of this condition, but that the most common infectious cause of these symptoms is:

• CMV

• Syphillis

• Parvovirus B19

• Toxoplasmosis

• Herpes simplex virus

Multiple Choice

During a prenatal ultrasound at 22 weeks gestation, a singleton fetus is noted to have ascites and pleural effusions. Which of the following additional complications is most likely to occur in the fetus?

• Congenital lobar emphysema

• Pneumothorax

• Anemia

• Renal vein thrombosis

• Biliary atresia

Multiple Choice

A 34 week gestation male is found to have malformations, atrophy, scarring of both lower extremities, and cataracts associated with micropthalmia and microcephaly. Review of maternal prenatal laboratory results, obtained when the patient's mother was in her 6th week of pregnancy, is most likely to reveal which of the following?

• RPR titer of 1:64

• Rubella nonimmune

• Varicella nonimmune

• Positive CMV DNA PCR

• Parvovirus nonimmune

Multiple Choice

A 4-lb female, born at 34 weeks of gestation, is noted to have a head circumference less than the 3rd percentile, bilateral cataracts, microphthalmia, and shortened, malformed lower extremities with numerous areas of scarring. Which of the following is the most likely cause of this patient's clinical findings?

• Cytomegalovirus acquired congenitally

• Varicella infection during the 1st trimester

• Rubella virus acquired congenitally

• Toxoplasmosis

Multiple Choice

A female infant born at term arrives in the NICU after a precipitous vaginal delivery. Her weight is at the 3rd percentile. Head circumference is below the 3rd percentile. On exam, a diffuse, maculopapular rash is noted, as is hepatosplenomegaly. Laboratory results include thrombocytopenia and elevated total and direct bilirubin. Cranial US reveals calcifications throughout the brain, which are especially prominent in the basal ganglion. Which of the following is the most likely etiology of this patient's findings?

• Treponema pallidum

• Rubella virus

• Cytomegalovirus

• Toxoplasma gondii

• Varicella-zoster virus