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Neonatal Infections

»	What are the TORCHES infections in a neonate?
»	Describe the cutaneous findings in neonatal herpes simplex viral (HSV) infections.
»	Is neonatal herpes simplex dangerous?
»	What percentage of herpes-infected neonates display skin or mucosal lesions?
»	What percentage of these lesions are HSV-1, as opposed to HSV-2?
»	What tests can be done to diagnose herpes infections? How should material be obtained for these tests?
»	What is congenital varicella syndrome?
»	What is the average age of onset of lesions in a neonate exposed to varicella perinatally? When is there an increased risk of mortality?
»	What is the treatment of neonatal HSV and varicella infection?
»	What is a “blueberry muffin baby”? What is the significance of this diagnosis?
»	At what time during pregnancy is there the highest risk of congenital rubella following maternal infection?
»	List the classic triad of congenital rubella syndrome (CRS).
»	Are any precautions necessary for infants with congenital rubella syndrome at the time of hospital discharge?
»	Why is human parvovirus infection important to a pregnant woman?
»	Are most infants with congenital cytomegalovirus (CMV) infection symptomatic?
»	What cutaneous findings are seen in congenital CMV infection?
»	What clinical findings are seen in congenital Epstein-Barr virus infection?
»	Describe a clinical presentation of congenital human papillomavirus infection.
»	What is the risk of HIV infection transmission to an infant born from an HIV-positive mother?
»	What is Hutchinson’s triad?
»	Are there any other stigmata of late congenital syphilis?
»	What are the physical findings of early congenital syphilis?

Describe a clinical presentation of congenital human papillomavirus infection.

Fig. 57.3 An infant with perianal warts. (Courtesy of William L. Weston, MD.)

The infant can present with voice changes or a persistent abnormal hoarse cry, due to laryngeal papillomas thought to be acquired during passage through the infected birth canal. The time between rupture of the amnion and delivery seems to be a critical factor in vertical transmission rate. These signs of infection may not be evident for several months to several years of age.

Anogenital warts in young children can also be acquired as a congenital infection, through sexual abuse, or by other postnatal, nonsexual contact with affected adults (Fig. 57-3).

Tenti P, Zappatore R, Migliora P, et al: Perinatal transmission of human papillomavirus from gravidas with latent infections, Obstet Gynecol 93:475–479, 1999.