Rubella, Congenital

• Pathogenesis: Risk is greatest with maternal infection in the 1st trimester
• Congenital defects in 85% when primary maternal infection occurs before the 4th week of gestation to 10-20% by the end of the first trimester

Presentation: (mnemonic: blueberry muffin-face, scratching out eyes and ears)

• General: IUGR
• Eyes: Cataracts, glaucoma, microophthalmia
• CV: Myocarditis, PDA, PPS
• Skin: “Blueberry muffin” (purpuric rash)
• CNS: Sensorineural hearing loss; later sequela are motor and mental retardation, behavior disorders
• Bone: Lucencies
• Heme: Anemia and thrombocytopenic purpura

Diagnosis: Nasopharyngeal culture or documented transition from non-immune to immune

• IgM or 4-fold increase in IgG

Prognosis: Poor

Prevention: Immunizations
 

CHLA Board Review 2005