Perinatal Infection

The immediate and long-term effects of perinatal infection are a major problem throughout the world. Perinatal infection is relatively common among the over 4 million births per year in the United States but the incidence is dependent upon the organism. One percent of newborn infants excrete cytomegalovirus. Fifteen percent are infected with Chlamydia trachomatis; one-third develop conjunctivitis and one-sixth, pneumonia. One to eight per 1,000 live births develop bacterial sepsis. In utero or perinatal infection with herpes simplex virus, Toxoplasma gondii and varicella-zoster virus occurs in about 1 per 1,000 live births and the sequelae may be severe. In-utero acquired infection may result in resorption of the embryo, abortion, stillbirth, malformation, intrauterine growth retardation, prematurity, and the numerous untoward sequelae associated with chronic infection. Infection acquired at or soon after birth may lead to death or persistent postnatal infection. Some infections may be inapparent at birth and present years later with signs (e.g., choreoretinitis of T. gondii, hearing loss of rubella virus, and immunologic defects of HIV). Early diagnosis and aggressive treatment of infection during pregnancy may lower the associated morbidity and mortality rates substantially.

88 □ Dermatology and Perinatal Infection BACTERIAL INFECTION

Cocci Lesions

Figure 2.1. Staphylococcal furunculosis developed in diis infant at die age of 6 days. A Gram stain of the material in the lesions showed numerous polymorphonuclear leukocytes and gram-positive cocci. The culture grew Staphylococcus aureus. Included in die differential diagnosis of diese lesions are transient neonatal pustular melanosis and herpes.

Figure 2.1. Staphylococcal furunculosis developed in diis infant at die age of 6 days. A Gram stain of the material in the lesions showed numerous polymorphonuclear leukocytes and gram-positive cocci. The culture grew Staphylococcus aureus. Included in die differential diagnosis of diese lesions are transient neonatal pustular melanosis and herpes.

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