A neonate is born at 38 weeks gestation age via spontaneous vaginal delivery to a 40-year-old woman. The mother was working in South America when she discovered that she was pregnant. She had 2 days of fever associated with cough and swollen cervical glands, which resolved spontaneously at 12 weeks gestation prior to returning to the United States. The mother has no current symptoms. Neonatal examination shows weight and length at the 8th percentile, and head circumference below the 3rd percentile for age. Heart and lung sounds are normal. There is moderate hepatosplenomegaly. Skin examination shows diffuse, dark-blue papules and nodules. Serology from the mother and infant are attained. Which of the following serology patterns is most consistent with a suspected congenital infection?

Question

A neonate is born at 38 weeks gestation age via spontaneous vaginal delivery to a 40-year-old woman.  The mother was working in South America when she discovered that she was pregnant.  She had 2 days of fever associated with cough and swollen cervical glands, which resolved spontaneously at 12 weeks gestation prior to returning to the United States.  The mother has no current symptoms.  Neonatal examination shows weight and length at the 8th percentile, and head circumference below the 3rd percentile for age.  Heart and lung sounds are normal.  There is moderate hepatosplenomegaly.  Skin examination shows diffuse, dark-blue papules and nodules.  Serology from the mother and infant are attained.  Which of the following serology patterns is most consistent with a suspected congenital infection?

Quizplus · Accepted Answer

Eductional Objective: Organism-specific IgM is diagnostic of congenital infection in a symptomatic neonate (eg, growth restriction, microcephaly, hepatosplenomegaly, blueberry muffin rash).  Because maternal IgG titers are expected with a past infection and neonatal IgG at birth is maternally derived, elevated newborn IgG is also expected.

A Neonate Is Born at 38 Weeks Gestation Age Via