00:01
Let’s switch gears one
more time to rubella.
00:05
Rubella is rare in the U.S.
because we have a vaccine,
the measles-mumps-rubella vaccine,
which is a great vaccine.
00:13
Rubella is an RNA virus.
00:15
And primary infection
is not such a big deal.
00:20
Patients will get a low-grade
fever, they’ll get headache,
maybe conjunctivitis, maybe
cough and congestion
And they will get a classic rash.
00:27
Here’s a classic rash of
a patient with rubella.
00:32
But it’s not really the primary infection
that we’re worried about in children.
00:37
What we’re worried about is the
other getting a primary infection
while the infant is inside them.
00:44
So if a mother acquires the
disease while she’s pregnant,
the infant can be
born stillborn.
00:53
Stillborn babies are reasonably
common with congenital rubella.
00:58
Or they may have a triad of symptoms.
01:01
So the classic triad of rubella is
cataracts, like we can see here,
deafness and cardiac defects.
01:10
So eyes, ears, and heart.
01:13
In addition to this triad, infants may
be born with blueberry muffin spots.
01:19
This is a commonly
tested question.
01:22
These muffin spots are different than the
rash I showed you in the previous patient.
01:26
That was just acquired rubella.
01:29
This is congenital rubella and they
develop these blue lesions in their skin.
01:35
These blue lesions are because there
is actually extramedullar hematopoiesis
going on in the skin in these infants.
01:44
Let’s switch gears now to
congenital CMV or cytomegalovirus.
01:49
This the most common congenital
infection in the United States.
01:54
Fortunately, the majority are asymptomatic.
01:57
But 10% will have symptoms at birth.
02:00
This will present as
prematurity, hepatosplenomegaly,
being small for gestational age,
having a small head, microcephaly, which
is similar to toxo, or having seizures.
02:12
They may also have late symptoms,
which include hearing, vision loss,
developmental delay or
a seizure disorder.
02:21
So early symptoms are fairly non-specific
except they do have microcephaly
and then later symptoms, they can
develop hearing and vision loss,
developmental delay
and seizures.