An approach to the diagnosis of congenital infections

Abstract

Remarkable progress has been made in preventing nonbacterial congenital infection through the use of rubella and measles immunizations, hepatitis B immunoprophylaxis, zidovudine treatment of human immunodeficiency virus (HIV)-infected mothers, and prompt diagnosis and treatment of maternal syphilis. Intrauterine diagnosis and effective therapy are available for congenital toxoplasmosis, and intrauterine diagnosis of parvovirus B19 infection enables life-saving in utero transfusion when necessary. Further, serious fetal damage evident on fetal ultrasound can be attributed to cytomegalovirus by amniotic fluid cultures, and there is greater understanding of the risk of herpes simplex infections (1). Even with these major strides, the paediatrician continues to be called on and challenged to identify the rare, infected neonate.