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__NOTOC__
__NOTOC__
{{CMG}} {{AE}} {{KD}}
{{Congenital rubella syndrome}}
{{Congenital rubella syndrome}}
{{CMG}}; {{AE}}{{DN}}


== Overview ==
== Overview ==
 
Congenital rubella syndrome affects multiple organ systems. The classic triad of congenital rubella syndrome consists of [[cataracts]], [[sensorineural hearing loss]] and [[patent ductus arteriosus (PDA)]]. However, many other findings are evident on physical examination, including [[low birth weight]], [[skin lesions]], and [[hepatosplenomegaly]].<ref name="pmid16580940">{{cite journal |vauthors=De Santis M, Cavaliere AF, Straface G, Caruso A |title=Rubella infection in pregnancy |journal=Reprod. Toxicol. |volume=21 |issue=4 |pages=390–8 |year=2006 |pmid=16580940 |doi=10.1016/j.reprotox.2005.01.014 |url=}}</ref><ref name="pmid25576992">{{cite journal |vauthors=Lambert N, Strebel P, Orenstein W, Icenogle J, Poland GA |title=Rubella |journal=Lancet |volume=385 |issue=9984 |pages=2297–307 |year=2015 |pmid=25576992 |pmc=4514442 |doi=10.1016/S0140-6736(14)60539-0 |url=}}</ref><ref name="pmid25654000">{{cite journal |vauthors=Ajij M, Nangia S, Dubey BS |title=Congenital rubella syndrome with blueberry muffin lesions and extensive metaphysitis |journal=J Clin Diagn Res |volume=8 |issue=12 |pages=PD03–4 |year=2014 |pmid=25654000 |pmc=4316306 |doi=10.7860/JCDR/2014/10271.5293 |url=}}</ref><ref name="pmid10696549">{{cite journal |vauthors=Bullens D, Smets K, Vanhaesebrouck P |title=Congenital rubella syndrome after maternal reinfection |journal=Clin Pediatr (Phila) |volume=39 |issue=2 |pages=113–6 |year=2000 |pmid=10696549 |doi= |url=}}</ref><ref name="pmid27002428">{{cite journal |vauthors=Yazigi A, De Pecoulas AE, Vauloup-Fellous C, Grangeot-Keros L, Ayoubi JM, Picone O |title=Fetal and neonatal abnormalities due to congenital rubella syndrome: a review of literature |journal=J. Matern. Fetal. Neonatal. Med. |volume=30 |issue=3 |pages=274–278 |year=2017 |pmid=27002428 |doi=10.3109/14767058.2016.1169526 |url=}}</ref>
[[Congenital rubella syndrome]] is characterized by triad of [[sensorineural deafness]], eye abnormalties ([[cataract]]s, [[retinopathy]]) and heart defects ([[PDA]]).


== Physical Examination ==
== Physical Examination ==
<ref name="pmid25654000">{{cite journal |vauthors=Ajij M, Nangia S, Dubey BS |title=Congenital rubella syndrome with blueberry muffin lesions and extensive metaphysitis |journal=J Clin Diagn Res |volume=8 |issue=12 |pages=PD03–4 |year=2014 |pmid=25654000 |pmc=4316306 |doi=10.7860/JCDR/2014/10271.5293 |url=}}</ref>
Congenital rubella syndrome affects multiple organ systems. The classic triad of congenital rubella syndrome consists of [[cataracts]], [[sensorineural hearing loss]], and [[patent ductus arteriosus (PDA)]]. However, many other findings are evident on physical examination and these include:<ref name="pmid16580940">{{cite journal |vauthors=De Santis M, Cavaliere AF, Straface G, Caruso A |title=Rubella infection in pregnancy |journal=Reprod. Toxicol. |volume=21 |issue=4 |pages=390–8 |year=2006 |pmid=16580940 |doi=10.1016/j.reprotox.2005.01.014 |url=}}</ref><ref name="pmid25576992">{{cite journal |vauthors=Lambert N, Strebel P, Orenstein W, Icenogle J, Poland GA |title=Rubella |journal=Lancet |volume=385 |issue=9984 |pages=2297–307 |year=2015 |pmid=25576992 |pmc=4514442 |doi=10.1016/S0140-6736(14)60539-0 |url=}}</ref><ref name="pmid25654000">{{cite journal |vauthors=Ajij M, Nangia S, Dubey BS |title=Congenital rubella syndrome with blueberry muffin lesions and extensive metaphysitis |journal=J Clin Diagn Res |volume=8 |issue=12 |pages=PD03–4 |year=2014 |pmid=25654000 |pmc=4316306 |doi=10.7860/JCDR/2014/10271.5293 |url=}}</ref><ref name="pmid10696549">{{cite journal |vauthors=Bullens D, Smets K, Vanhaesebrouck P |title=Congenital rubella syndrome after maternal reinfection |journal=Clin Pediatr (Phila) |volume=39 |issue=2 |pages=113–6 |year=2000 |pmid=10696549 |doi= |url=}}</ref><ref name="pmid27002428">{{cite journal |vauthors=Yazigi A, De Pecoulas AE, Vauloup-Fellous C, Grangeot-Keros L, Ayoubi JM, Picone O |title=Fetal and neonatal abnormalities due to congenital rubella syndrome: a review of literature |journal=J. Matern. Fetal. Neonatal. Med. |volume=30 |issue=3 |pages=274–278 |year=2017 |pmid=27002428 |doi=10.3109/14767058.2016.1169526 |url=}}</ref><ref name="pmid3890105">{{cite journal |vauthors=Cooper LZ |title=The history and medical consequences of rubella |journal=Rev. Infect. Dis. |volume=7 Suppl 1 |issue= |pages=S2–10 |year=1985 |pmid=3890105 |doi= |url=}}</ref><ref name="pmid15064032">{{cite journal |vauthors=Banatvala JE, Brown DW |title=Rubella |journal=Lancet |volume=363 |issue=9415 |pages=1127–37 |year=2004 |pmid=15064032 |doi=10.1016/S0140-6736(04)15897-2 |url=}}</ref><ref name="pmid4164540">{{cite journal |vauthors=Cooper LZ, Krugman S |title=Clinical manifestations of postnatal and congenital rubella |journal=Arch. Ophthalmol. |volume=77 |issue=4 |pages=434–9 |year=1967 |pmid=4164540 |doi= |url=}}</ref><ref name="pmid5815335">{{cite journal |vauthors=Cooper LZ, Ziring PR, Ockerse AB, Fedun BA, Kiely B, Krugman S |title=Rubella. Clinical manifestations and management |journal=Am. J. Dis. Child. |volume=118 |issue=1 |pages=18–29 |year=1969 |pmid=5815335 |doi= |url=}}</ref>
{| class="wikitable" style="border: 2; background: none;"
{| class="wikitable" style="border: 2; background: none;"
! colspan="1" rowspan="1" style="border: 1; background: 1;" |Organ System
! colspan="1" rowspan="1" style="border: 1; background: 1;" |Organ System
Line 16: Line 13:
! colspan="3" rowspan="1" |Suggestive of
! colspan="3" rowspan="1" |Suggestive of
|-
|-
! rowspan="2" style="border: 1; background: none;" |Skin
|'''General Appearance'''
|[[Low birth weight]]
|
|-
| rowspan="2" style="border: 1; background: none;" |'''Skin'''
|[[Skin lesions]] of several sizes ([[petechiae]] and [[purpura]])
|[[Skin lesions]] of several sizes ([[petechiae]] and [[purpura]])
||[[Thrombocytopenic purpura]]
||[[Thrombocytopenic purpura]]
Line 23: Line 24:
|[[Obstructive jaundice]]
|[[Obstructive jaundice]]
|-
|-
! rowspan="4" style="border: 1; background: none;" |Eyes
| rowspan="4" style="border: 1; background: none;" |'''Eyes'''
|Clouding of the [[Cornea|corneas]]
|Clouding of the [[Cornea|corneas]]
||[[Cataracts]]
||[[Cataracts]]
Line 34: Line 35:
|[[Obstructive jaundice]]
|[[Obstructive jaundice]]
|-
|-
! rowspan="1" style="border: 1; background: none;" |Ears
| rowspan="1" style="border: 1; background: none;" |'''Ears'''
|||[[Sensorineural hearing loss]]
|||[[Sensorineural hearing loss]]
|-
|-
! rowspan="4" style="border: 1; background: none;" |'''Heart'''
| rowspan="4" style="border: 1; background: none;" |'''Heart'''
|||[[Ventricular septal defect|Ventricular septal defect (VSD)]]
|[[Holosystolic murmur]], best heard at the left lower sternal border
||[[Ventricular septal defect|Ventricular septal defect (VSD)]]
|-
|-
|||[[Patent ductus arteriosus (PDA)]]
|[[Gibson's murmur|Continuous, machinery murmur]], best heard at the left infraclavicular area
||[[Patent ductus arteriosus (PDA)]]
|-
|-
|Pansystolic [[murmur]] in the 2nd left [[intercostal space]]
|
* [[Midsystolic murmur]], best heard at the left infraclavicular area
* [[Continuous murmur]] due to the formation of [[collaterals]]
|[[Aortic coarctation|Coarctation of the aorta]]
|[[Aortic coarctation|Coarctation of the aorta]]
|-
|-
Line 48: Line 53:
|[[Pulmonary artery stenosis]]
|[[Pulmonary artery stenosis]]
|-
|-
! style="border: 1; background: none;" |Abdomen
| style="border: 1; background: none;" |'''Abdomen'''
|[[Hepatosplenomegaly|Hepatosplenomegaly (HSM)]]||
|[[Hepatosplenomegaly|Hepatosplenomegaly (HSM)]]||
|-
|-
! rowspan="3" |Neurological
| rowspan="2" |'''Neurological'''
|Small [[head]] circumference
|Small [[head]] circumference
|[[Microcephaly]]
|[[Microcephaly]]
|-
|-
|
|[[Seizures]], [[irritability]], bulging [[anterior fontanelle]]
|[[Encephalitis]]
|[[Encephalitis]]
|-
|
|[[Mental retardation]]
|}
|}
*
 
<gallery>
Image: CRS_retinopathy.jpg|300px|left|"Salt and pepper" [[retinopathy]] is the most common [[ocular]] manifestation of CRS. - By Jonathan Trobe, M.D. - University of Michigan Kellogg Eye Center - http://www.kellogg.umich.edu/theeyeshaveit/congenital/retinopathy.html, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=16115881
 
Image: CRS_cataract.jpg|300px|A child with congenital [[cataracts]] as a consequence of CRS. - By CDC - PHIL, Center for Disease Control (CDC) -- ID# 713, Public Domain, https://commons.wikimedia.org/w/index.php?curid=12841764
 
Image: CRS_skin.jpg|300px|"Blueberry muffin" skin lesions, indicative of CRS. - By http://phil.cdc.gov/phil_images/20030724/28/PHIL_4284_lores.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=821959
 
</gallery>


== References ==
== References ==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Emergency medicine]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Pediatrics]]
[[Category:Pediatrics]]
[[Category:Neonatology]]
[[Category:Obstetrics]]
[[Category:Congenital disorders]]
[[Category:Infectious disease]]
[[Category:Syndromes]]

Latest revision as of 21:04, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]

Overview

Congenital rubella syndrome affects multiple organ systems. The classic triad of congenital rubella syndrome consists of cataracts, sensorineural hearing loss and patent ductus arteriosus (PDA). However, many other findings are evident on physical examination, including low birth weight, skin lesions, and hepatosplenomegaly.[1][2][3][4][5]

Physical Examination

Congenital rubella syndrome affects multiple organ systems. The classic triad of congenital rubella syndrome consists of cataracts, sensorineural hearing loss, and patent ductus arteriosus (PDA). However, many other findings are evident on physical examination and these include:[1][2][3][4][5][6][7][8][9]

Organ System Findings Suggestive of
General Appearance Low birth weight
Skin Skin lesions of several sizes (petechiae and purpura) Thrombocytopenic purpura
Yellow discoloration of the skin and mucous membranes Obstructive jaundice
Eyes Clouding of the corneas Cataracts
Congenital glaucoma
Pigmentary retinopathy
Yellow discoloration of the sclera Obstructive jaundice
Ears Sensorineural hearing loss
Heart Holosystolic murmur, best heard at the left lower sternal border Ventricular septal defect (VSD)
Continuous, machinery murmur, best heard at the left infraclavicular area Patent ductus arteriosus (PDA)
Coarctation of the aorta
Pulmonary artery stenosis
Abdomen Hepatosplenomegaly (HSM)
Neurological Small head circumference Microcephaly
Seizures, irritability, bulging anterior fontanelle Encephalitis

References

  1. ↑ 1.0 1.1 De Santis M, Cavaliere AF, Straface G, Caruso A (2006). "Rubella infection in pregnancy". Reprod. Toxicol. 21 (4): 390–8. doi:10.1016/j.reprotox.2005.01.014. PMID 16580940.
  2. ↑ 2.0 2.1 Lambert N, Strebel P, Orenstein W, Icenogle J, Poland GA (2015). "Rubella". Lancet. 385 (9984): 2297–307. doi:10.1016/S0140-6736(14)60539-0. PMC 4514442. PMID 25576992.
  3. ↑ 3.0 3.1 Ajij M, Nangia S, Dubey BS (2014). "Congenital rubella syndrome with blueberry muffin lesions and extensive metaphysitis". J Clin Diagn Res. 8 (12): PD03–4. doi:10.7860/JCDR/2014/10271.5293. PMC 4316306. PMID 25654000.
  4. ↑ 4.0 4.1 Bullens D, Smets K, Vanhaesebrouck P (2000). "Congenital rubella syndrome after maternal reinfection". Clin Pediatr (Phila). 39 (2): 113–6. PMID 10696549.
  5. ↑ 5.0 5.1 Yazigi A, De Pecoulas AE, Vauloup-Fellous C, Grangeot-Keros L, Ayoubi JM, Picone O (2017). "Fetal and neonatal abnormalities due to congenital rubella syndrome: a review of literature". J. Matern. Fetal. Neonatal. Med. 30 (3): 274–278. doi:10.3109/14767058.2016.1169526. PMID 27002428.
  6. ↑ Cooper LZ (1985). "The history and medical consequences of rubella". Rev. Infect. Dis. 7 Suppl 1: S2–10. PMID 3890105.
  7. ↑ Banatvala JE, Brown DW (2004). "Rubella". Lancet. 363 (9415): 1127–37. doi:10.1016/S0140-6736(04)15897-2. PMID 15064032.
  8. ↑ Cooper LZ, Krugman S (1967). "Clinical manifestations of postnatal and congenital rubella". Arch. Ophthalmol. 77 (4): 434–9. PMID 4164540.
  9. ↑ Cooper LZ, Ziring PR, Ockerse AB, Fedun BA, Kiely B, Krugman S (1969). "Rubella. Clinical manifestations and management". Am. J. Dis. Child. 118 (1): 18–29. PMID 5815335.
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