- Cytomegalovirus (CMV)
- Hepatitis B virus (HBV)
- Herpes simplex virus
- Human immunodeficiency virus (HIV)
- Human papillomavirus (HPV)
- Resources In This Article
Some Infections in Newborns
Some infections that can affect people of all ages cause particular problems when they occur in a fetus or newborn. (See also Zika Virus Infection.)
Candidiasis is infection by Candida, a type of yeast or fungus.
White spots or patches caused by Candida develop in the mouth (thrush). Thrush sometimes causes pain and might make it difficult for the newborn to feed.
Sometimes, newborns develop a diaper rash caused by Candida, which may be painful.
Rarely, newborns develop Candida infections in their blood, spinal fluid, or organs. These infections occur especially in premature newborns or very sick newborns in the hospital.
Conjunctivitis is inflammation of the conjunctiva, the membrane that lines the eyelid and covers the white of the eye. Conjunctivitis in newborns can be caused by an infection or by a reaction to drugs put into their eyes.
Chlamydia: Conjunctivitis usually begins 5 to 14 days after delivery but sometimes 6 weeks after.
Newborns have swollen eyelids and a watery discharge from the eyes that contains increasing amounts of pus.
Neisseria gonorrhoeae: Conjunctivitis usually begins 2 to 5 days after delivery.
Newborns have severe inflammation of the eyelids and discharge of pus from the eyes.
Without treatment, blindness may occur.
Cytomegalovirus is a common virus that usually causes few or no problems but can cause serious illness in infants who are infected before birth.
Most newborns who have CMV do not have symptoms, but about 10% have problems at birth that may include prematurity, a low birth weight, a small head, growth delay, jaundice, bruises, inflammation of the lungs or eyes, an enlarged liver and spleen, anemia, a low platelet count, and a high or low number of white blood cells.
CMV may cause death, and the outcome for survivors is highly variable. Hearing loss develops in about 10% of children as they grow older and may occur up to 6 years of age. Neurodevelopmental delays and intellectual disability are frequent long-term problems.
Treatment of cytomegalovirus infection involves the use of antiviral drugs such as ganciclovir or valganciclovir. However, these drugs can be toxic to the newborn because they may lower the white blood cell count and possibly damage the liver and kidneys. Because of these complications, these drugs are not recommended for infants who have no signs of problems caused by CMV and who pass the newborn hearing test.
Doctors are not sure whether drug treatment decreases the risk of further hearing loss in infants who have no symptoms but who fail the newborn hearing test.
Research is showing that treatment of symptomatic infants improves outcomes in terms of hearing loss and neurodevelopment.
Periodic hearing evaluations are recommended for CMV-infected children in infancy and early childhood.
Of the 5 types of hepatitis virus, hepatitis B is the one of concern in newborns. This infection rarely causes severe illness in newborns but it is highly likely to progress to a chronic infection. About 90% of newborns with HBV develop chronic infection, compared to a 5% rate of chronic infection in adults. Chronic hepatitis B infection in newborns progresses to liver cirrhosis and/or liver cancer in about 25% of cases, so it is very important to prevent hepatitis B infection in newborns.
All newborns are given hepatitis B vaccine at birth. The vaccine is highly effective in reducing the chances of a hepatitis B infection. If the mother's blood tests indicate the potential to infect the baby at birth, newborns are also given hepatitis B immune globulin, a preparation of antibodies against hepatitis B. The vaccine and the immune globulin are given within 12 hours of birth.
The herpes simplex virus usually causes only annoying, recurring sores in healthy adults but can cause life-threatening infection in newborns.
Usually, a rash of small fluid-filled blisters appears between the first and third weeks of life.
Some newborns do not have a rash but are severely ill with a widespread infection that affects many organs, such as the eyes, lungs, liver, brain, and skin.
Other symptoms include sluggishness, diminished muscle tone, respiratory distress, pauses in breathing (apnea), and seizures.
Mothers who have herpes have a low risk of transmitting herpes to their newborn. This risk is further decreased if mothers are given the antiviral drugs acyclovir or valacyclovir beginning at 36 weeks gestation. If mothers have an active herpes infection at the time of delivery, a cesarean delivery (C-section) may be done to decrease the risk of infection of the newborn. Newborns at high risk of herpes infection are tested for herpes when they are 24 to 48 hours old and may be treated with antiviral drugs depending on the results of the tests. Newborns who have a rash or who have symptoms that suggest a herpes infection are typically treated with acyclovir.
Eye infections are treated with trifluridine, iododeoxyuridine, or vidarabine drops as well.
HIV infection is a viral infection that progressively destroys certain white blood cells and causes acquired immunodeficiency syndrome (AIDS).
Symptoms range from none during the first few months of life to very severe (AIDS) if not treated.
When untreated, the lymph nodes may swell.
Infection can affect many organs such as the liver, spleen, heart, kidneys, brain, and spinal cord.
Symptoms can also include developmental delays, pneumonia, recurring diarrhea, poor weight gain, invasive bacterial infections, and viral and fungal infections.
There are over 100 types of HPV, some of which cause common skin warts and some of which cause genital warts. Some of the types that cause genital warts can cause cancer.
Warts are removed surgically.
The drug interferon can reduce the risk of recurring infections. However, the most effective approach is to prevent infection by giving the HPV vaccine, which is given to boys and girls 11 to 12 years of age. Adolescents and young adults who were never vaccinated or who did not receive all the doses can be vaccinated up to age 26.
Rubella is a typically mild childhood viral infection that may, however, have devastating consequences for infants infected before birth.
Effects on the newborn range from death before birth to birth defects or to hearing loss without other symptoms.
Newborns may have a low birth weight, brain inflammation, cataracts, damage to the retina, heart defects, an enlarged liver and spleen, bruising, bluish red spots, enlarged lymph nodes, and pneumonia.
No specific treatment is available.
Vaccinating all girls in infancy and women of childbearing age before pregnancy can prevent infection in the fetus.
If an expectant mother who has not been immunized comes into close contact with an infected person early in pregnancy, she may be given an injection of immune globulin.
Syphilis is a sexually transmitted disease caused by the bacteria Treponema pallidum. It causes a variety of problems in adults and has serious consequences for infants infected before birth.
Newborns may have no symptoms.
During the first 3 months of life, large blisters or a flat copper-colored rash may develop on palms and soles. Raised bumps may develop around the nose and mouth and in the diaper area. Newborns may not grow well. They may have cracks around the mouth, or mucus, pus, or blood may run from the nose.
Usually, the lymph nodes, liver, and spleen are enlarged.
Rarely, inflammation of the eye or brain, seizures, meningitis, or intellectual disability occurs, but these symptoms may not appear until the child is age 2 years or older.
Toxoplasmosis is an infection with the parasite Toxoplasma gondii. It usually does not cause problems in healthy adults, but can cause serious illness in newborns and people with a weakened immune system. If a woman becomes infected with the parasite during pregnancy, it may cross the placenta and infect the fetus.
Cats are the main reservoir of Toxoplasma gondii, and cat feces contaminate soil and water. Humans and animals become infected by ingesting material contaminated with cat feces or undercooked meat from infected animals. Touching contaminated material, particularly cat feces or soil contaminated by cat feces, can allow the parasite to be transferred to food. Thus, common sources of infection include eating raw vegetables or undercooked meat (particularly beef, lamb, pork, or game meats) or meat products (such as raw sausages, salami, and cured meats).
Infection of the fetus is more severe if the infection occurs early in pregnancy.
Pregnant women who become infected with Toxoplasma gondii may have a flu-like illness with fever, headache, fatigue, and swelling of the lymph nodes, but, in most cases, there are no noticeable symptoms.
Most infected fetuses have no symptoms at the time of birth, but about 10% have signs of infection that include low birthweight, prematurity, a rash, a small head (microcephaly) or a very large head with fluid (hydrocephalus), brain inflammation, anemia, jaundice, an enlarged liver and spleen, and inflammation of the heart, lungs, and eyes.
Unfortunately, even newborns without signs of infection at birth may still have long-term complications including eye problems (which may progress to blindness), hearing loss, poor overall growth related to hormonal disturbances, reduced growth of the head, intellectual disability, and seizures.
Toxoplasma gondii antibody levels in blood early in pregnancy can determine whether a women is susceptible to toxoplasmosis. Women who have had such an infection in the past are not at risk of another infection. Repeat blood tests later in pregnancy can be used to determine whether the mother has become infected, and additional tests for Toxoplasma gondii DNA in amniotic fluid (obtained by amniocentesis) can determine whether there is infection in the fetus.
Newborns may be suspected of having toxoplasmosis based on the mother's history and the examination of the baby. Infection is confirmed by testing for antibodies in the newborn's blood and finding Toxoplasma gondii DNA in the newborn's blood and/or body fluids.
Pregnant women should avoid handling cat litter and should not eat raw vegetables or undercooked meat or meat products. The processes used to cure meat do not kill the Toxoplasma gondii parasite.
If a mother becomes infected early in pregnancy and the fetus is not infected, she may be given spiramycin to reduce the risk of transmitting the infection to the fetus. Infections in the fetus or newborn (with or without symptoms) are treated with pyrimethamine and sulfadiazine.