Symptomatic neonatal CNS involvement is most commonly seen in which group of congenital intrauterine infection?
High-Yield Explanation
c. Rubella and HSV(Ref: Nelson's 20/e p 1548-1551)Symptomatic CNS infections in neonatal period are most commonly seen in HSV (75-100%) f/b Rubella (30-60%);CMV, toxoplasma, and syphillis become symptomatic in less than 10%-15% of cases.Characteristic clinical features of Intrauterine InfectionsInfectionIUGRHSMBleedingEye signsCNS featuresOthersConge-nital CMV disease60-70%2/3rd of patients"Blue berry muffinspots""Cottage cheese with Ketchup" choriore-tinitis,sparing of macula, optic atrophyMicro-cephaly, periven-tricular calcifi-cation,mental retardationAnemia, sensori-neural deafness, pneumoniaConge-nitalRubella60%60-70%50-60%Cataracts, glaucoma, corneal opacity,salt& pepper choriore-tinitisMeningo-encephalitis, deafness, mental retardationCardiac defects like PDA, PS, VSD; bone lesionsConge-nital Toxopla-smosis20-30%40-50%30-40%Choriore-tinitis with macular involve-ment, optic atrophy, cataract, uveitisHydroc-ephalus, microce-phaly, Diffuse cerebral calcifi-cationStrabismus, nystagmus, visual impairmentConge-nitalsyphilisUncom-mon30-40%Uncom-monInterstitial Keratitis, Choriore-tinitisMeningo-encepha-litisRashes, snuffles,periosteitis, chondritis, deafnessConge-nitalVaricellaLBWcommonUncom-monUncom-monChoriore-tinitis, microph-thalmia, and cataractsMicroce-phaly, cortical atrophy, seizures, ID, neurogenic bladder, swallowing dysfunctioncicatricial skin scarring in a zoster-like distrib-ution; limb hypoplasia; hydron-ephrosisHerpessimplexNone50%Uncom-monKeratitis, Conjun-ctivitis, Choriore-tinitis, CataractsMeningo-encephalitis, micro-cephaly, Intracranial CalcificationVesicles, Pneumonia, Hepatitis, mucocu-taneous lesions