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1/373. Fetal meconium peritonitis after maternal hepatitis A.

    hepatitis a virus has rarely been implicated in congenital infections. After maternal hepatitis A at 13 weeks' gestation, ultrasonographic examinations revealed fetal ascites (20 weeks) and meconium peritonitis (33 weeks). After delivery, a perforated distal ileum was resected. Elevated levels of hepatitis A immunoglobulin g persisted in the infant 6 months after delivery.
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ranking = 1
keywords = virus
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2/373. prenatal diagnosis of congenital varicella syndrome and detection of varicella-zoster virus in the fetus: a case report.

    Varicella syndrome (VS) specific malformations were sonographically seen at 22 weeks and 3 days of gestation. Fetal infection was demonstrated by detection of varicella-zoster virus (VZV) dna in fetal blood and amniotic fluid by polymerase chain reaction (PCR). Following therapeutic abortion, fetal infection was confirmed by detection of VZV dna in several fetal tissues and placenta, and by histopathological findings like miliary calcified necroses in fetal organs.
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ranking = 5
keywords = virus
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3/373. Immunizations in pregnancy. A public health perspective.

    With the successful implementation of childhood immunization programs in the united states, an increasing percentage of vaccine-preventable infections now occur in adults. By providing primary care services to adult women, midwives are in a unique position to halt the spread of these infections. Immunizations are often avoided in pregnancy and the early post partum period, however, in the mistaken belief that vaccines are harmful to the fetus or neonate. This article, the first in a two-part series on immunizations, reviews the current epidemiology of vaccine-preventable diseases, discusses the indications and precautions for vaccine usage in pregnancy and the early postpartum period, and presents the current recommendations from the American Committee on Immunization Practices for the most commonly administered adult immunizations: tetanus-diphtheria, hepatitis b, influenza, pneumococcal, measles, mumps, rubella, and varicella.
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keywords = measles
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4/373. Hyperimmunoglobulin therapy for a twin fetus with cytomegalovirus infection and growth restriction.

    OBJECTIVE: cytomegalovirus immunoglobulin was administered to a pregnant woman with primary cytomegalovirus infection and placental involvement of 1 twin fetus, in whom growth restriction had developed. STUDY DESIGN: Inhibition of viral activity was attempted by administration of high-titer cytomegalovirus neutralizing antibodies for therapy of the involved fetoplacental unit and prevention of cytomegalovirus infection in the uninfected twin fetus. RESULTS: After cytomegalovirus immunoglobulin infusions the placental edema decreased and the infected fetus started to grow once again, showing at birth only hepatosplenomegaly associated with viruria and cytomegalovirus deoxyribonucleic acidemia. Moreover, cytomegalovirus immunoglobulin g avidity increased and cell-mediated immunity improved. The other twin, who had negative results of cytomegalovirus culture and deoxyribonucleic acid detection at birth, was found to have cytomegalovirus deoxyribonucleic acid in the urine after 1 week. From the age of 9 months, however, both twins had persistent negative results of cytomegalovirus deoxyribonucleic acid detection. CONCLUSION: Although large-scale studies are needed to establish the real efficacy and the best therapeutic regimen, cytomegalovirus immunoglobulin may be considered for treatment or prevention of fetal cytomegalovirus infection.
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ranking = 16
keywords = virus
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5/373. hiv surveillance: a dynamic, not static, process to assure accurate local data.

    BACKGROUND AND OBJECTIVES: Accurate human immunodeficiency virus (hiv) surveillance data is critical for the allocation of resources for care services and community prevention planning efforts. GOAL OF THIS STUDY: To validate hiv status of women and assess risk factor information on all persons reported with either heterosexual transmission or no identifiable risk factor. STUDY DESIGN: The surveillance database is updated continually as additional information is received on all cases allowing continual monitoring of pregnant and nonpregnant women. Repeated queries of various record systems were employed to validate or reclassify reported heterosexual or no identifiable risk factor information for both men and women. RESULTS: Four pregnant women (24%) and one nonpregnant woman (0.4%) initially meeting hiv surveillance criteria were demonstrated not to be infected. risk factors were validated or reclassified for 77 (58%) patients initially reported with heterosexual transmission or no identifiable risk. CONCLUSION: hiv surveillance should be a dynamic process and continual updating of case reports provides the most accurate information on which to base service and prevention decisions.
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6/373. Sequential peripartum herpes simplex virus type 2 disease in parents and their newborn mimicking intrafamily spread of common viruses.

    herpes simplex type 2 (HSV2) disease developed sequentially among two parents and their newborn. The father first became ill with upper-respiratory symptoms and fever. Then, 5 days later, shortly after delivery, the mother had fever, pharyngitis, and diarrhea. Subsequently, the infant developed undifferentiated febrile illness at the age of 3 days. HSV etiology was recognized by incidental isolation of HSV2 from the newborn naospharynx. The father never developed genital lesions and the mother's symptoms remained nonspecific for several days prior to the onset of genital manifestations. The sequential emergence and manifestations of these infections could have been misconstrued for an intrafamily spread of respiratory or enteric viruses. This cluster illustrates that HSV2 may cause sequential symptomatic disease in susceptible individuals mimicking other viruses.
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ranking = 10
keywords = virus
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7/373. herpes simplex hepatitis in pregnancy: a case report and review of the literature.

    Fulminant hepatic dysfunction in the third trimester of pregnancy accompanied by fever may result from disseminated herpes simplex virus. Since 1969, 24 cases of herpes simplex hepatitis, including the current case, have been reported. Mucocutaneous lesions are present in only half of cases; therefore, suspicion for diagnosis of this disease is low. Twenty-five percent of cases were not diagnosed until autopsy. Maternal and perinatal mortality are high, approaching 39 percent for both mother and fetus. Early recognition with initiation of antiviral therapy appears to be most important in maximizing survival.
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keywords = virus
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8/373. Successful treatment of generalized primary herpes simplex type 2 infection during pregnancy.

    Generalized herpes simplex virus infections constitute a severe threat to mother and child during pregnancy. Before antiviral treatments were available, both mother and foetus had a high mortality rate. The following case illustrates a successful outcome after long-term antiviral treatment. It is of great importance to suspect, diagnose and treat patients with HSV 2 early, especially during pregnancy.
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ranking = 1
keywords = virus
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9/373. Management of four pregnant women with multidrug-resistant tuberculosis.

    This case series describes the medical management of four pregnant women with active multidrug-resistant tuberculosis. None of the four patients were infected with human immunodeficiency virus. Three patients had disease due to multidrug-resistant mycobacterium tuberculosis, and one had disease due to multidrug-resistant mycobacterium bovis. Only one patient (patient 3) began retreatment during pregnancy, because her organism was susceptible to three antituberculosis drugs that were considered nontoxic to the fetus. Despite concern over teratogenicity of the second-line antituberculosis medications, careful timing of treatment initiation resulted in clinical cure for the mothers, despite some complications due to chronic tuberculosis and/or therapy. All infants were born healthy and remain free of tuberculosis. pregnancy and multidrug-resistant tuberculosis need not be a public health disaster, as both conditions can be managed concurrently and successfully.
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ranking = 1
keywords = virus
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10/373. Fetal brain infection with human parvovirus B19.

    Intrauterine parvovirus B19 infection is known to be one of the causes of hydrops fetalis. However, there are few reports of the pathologic changes in the central nervous system. Postmortem examination of a fetus revealed multinucleated giant cells of macrophage/microglia lineage and many small calcifications around the vessels, predominantly in the cerebral white matter. parvovirus B19 genome dna was detected in the nucleus of the multinucleated giant cells and solitary endothelial cells by polymerase chain reaction amplification and in situ polymerase chain reaction methods. capsid antigen was also demonstrated in the cytoplasm of the endothelial cells by immunofluorescent assay. Thus, intrauterine B19 parvovirus infection could be associated with marked neuropathologic changes in the fetal brain at the midembryonal period. Neurologic follow-up of complications may be necessary for children who survive the intrauterine infection.
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ranking = 7
keywords = virus
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