Congenital rubella: Difference between revisions

Latest revision as of 23:24, 21 September 2020

Background

Risk of transmission is 90% for mother's infected in the first trimester

Pathophysiology

Transplacental transfer of rubella virus occurs during viremia, which peaks about 5 to 7 days following infection of mother
- Mother may be asymptomatic

Clinical Manifestations

Spectrum of disease, which includes intra-uterine fetal demise, preterm delivery, and the congenital rubella syndrome
Severity depends in part on timing of infection
- Up to 8 weeks gestation: 20% chance of spontaneous abortion
- Up to 10 weeks: 90% chance of congenital rubella syndrome (severe defects)
- 13-18 weeks: 10-20% chance of hearing loss and retinopathy
- Congenital defects are unlikely if infection happens after 18 to 20 weeks gestation
- Intra-uterine growth restriction is likely only effect in third trimester
Most children are asymptomatic at birth, but can develop signs and symptoms after several years

Congenital Rubella Syndrome

Sensorineural hearing loss (most common findings), blueberry muffin rash (from extramedullary hematopoiesis), cataracts, glaucoma, congenital heart disease, and cognitive defects
Low birth weight, thrombocytopenic purpura, hepatosplenomegaly, meningoencephalitis, retinopathy, patent ductus arteriosus, pulmonary stenosis, developmental disorders, cryptorchidism, inguinal hernia
By the second decade of life, it can cause a progressing, fatal panencephalitis

@@ Line 1: / Line 1: @@
-== Background ==
+==Background==
-=== Pathophysiology ===
-* Transplacental transfer of virus occurs during viremia, which peaks about 5 to 7 days following infection of mother
+* Risk of transmission is 90% for mother's infected in the first trimester
-== Clinical Presentation ==
-* Spectrum of disease, which includes [[Causes::intra-uterine fetal demise]], [[Causes::preterm delivery]], and the congenital rubella syndrome
-* Severity depends in part on timing of infection
-** Infection in first trimester has 80% chance of defects
-** Congenital defects are unlikely if infection happens after 18 to 20 weeks gestation
-** [[Causes::Intra-uterine growth restriction]] is likely only effect in third trimester
-* Most children are asymptomatic at birth, but can develop signs and symptoms after several years
-* [[Causes::Deafness]], [[Causes::cataracts]], [[Causes::glaucoma]], [[Causes::congenital heart disease]], and [[Causes::cognitive defects]]
-* [[Causes::Low birth weight]], [[Causes::thrombocytopenic purpura]], [[Causes::hepatosplenomegaly]], [[Causes::meningoencephalitis]], [[Causes::retinopathy]], [[Causes::patent ductus arteriosus]], [[Causes::pulmonary stenosis]], developmental disorders, [[Causes::cryptorchidism]], inguinal hernia
-* By the second decade of life, it can cause a progressing, fatal [[Causes::panencephalitis]]
+===Pathophysiology===
-[[Category:Pediatrics]]
-[[Category:RNA viruses]]
+*Transplacental transfer of [[rubella virus]] occurs during viremia, which peaks about 5 to 7 days following infection of mother
+**Mother may be asymptomatic
+==Clinical Manifestations==
+*Spectrum of disease, which includes [[Causes::intra-uterine fetal demise]], [[Causes::preterm delivery]], and the congenital rubella syndrome
+*Severity depends in part on timing of infection
+**Up to 8 weeks gestation: 20% chance of spontaneous abortion
+**Up to 10 weeks: 90% chance of congenital rubella syndrome (severe defects)
+**13-18 weeks: 10-20% chance of hearing loss and retinopathy
+**Congenital defects are unlikely if infection happens after 18 to 20 weeks gestation
+**[[Causes::Intra-uterine growth restriction]] is likely only effect in third trimester
+*Most children are asymptomatic at birth, but can develop signs and symptoms after several years
+===Congenital Rubella Syndrome===
+*[[Causes::Sensorineural hearing loss]] (most common findings), blueberry muffin rash (from extramedullary hematopoiesis), [[Causes::cataracts]], [[Causes::glaucoma]], [[Causes::congenital heart disease]], and [[Causes::cognitive defects]]
+*[[Causes::Low birth weight]], [[Causes::thrombocytopenic purpura]], [[Causes::hepatosplenomegaly]], [[Causes::meningoencephalitis]], [[Causes::retinopathy]], [[Causes::patent ductus arteriosus]], [[Causes::pulmonary stenosis]], developmental disorders, [[Causes::cryptorchidism]], inguinal hernia
+*By the second decade of life, it can cause a progressing, fatal [[Causes::panencephalitis]]
+[[Category:Congenital infections]]