907 Diagnosing Infectious Mononucleosis in Primary Care - Case Studies from a Pediatric Outpatient Clinic

Abstract

AbstractsMethods A questionnaire was administered that addressed gender, age, number of household members, monthly family income, history of jaundice and immunization, number of rooms in the house, education level of the parents, day-care/school attendance, and type of water supply. The socioeconomic status score of each child was determined by summing the scores for monthly family income, education level of the parents, number of rooms in the house and number of people living in the house. Blood samples were collected and analyzed for anti-HAV IgG. Results Significant associations between anti-HAV seropositivity and socioeconomic status, age under 6 years old and attending daycare, a history of jaundice and monthly family income were found (p<0.001, p=0.003, p<0.001, p=0.04, respectively). Only the association between the history of jaundice and anti-HAV seropositivity remained significant in the multivariate analysis, with an adjusted Odds ratio of 13.1 (range: 2.9-59.5; p=0.001). Conclusions Our findings showed an inverse correlation between HAV seropositivity and socioeconomic status. A high in-house population and paternal education level were not a significant factor increasing the risk of anti-HAV positivity. However, as the maternal education level increased, less HAV positivity was recorded. Background and Aims Toxoplasmosis is a cosmopolitan infection caused by Toxoplasma gondii, clinical features varying from asymptomatic infection to severe systemic manifestations. Brazil has one of the highest incidence rates of congenital toxoplasmosis in the world with estimated rates of 1:3000 live births. Knowledge of the incidence, etiology, pathogenesis, diagnosis and management of infections during pregnancy, childbirth and neonatal period is relevant because it may cause damage to the fetus and newborn, representing a public health problem worldwide. The aim of this study is evaluate the quality of neonatal screening for congenital toxoplasmosis. Methods Retrospective study based on data collected from the medical records of 39 newborns Alcides Carneiro Hospital (HAC) in Petropolis, Rio de Janeiro, Brazil, from July 2010 to February 2012 whose mothers had seroconversion for toxoplasmosis during pregnancy. We analyzed maternal serology and treatment and clinical manifestations, laboratory and radiological newborn. Results Forty percent of pregnant women under which seroconverted in the 3rd trimester of pregnancy, 33% at 2 and 13% in first trimester. Underwent treatment 35%, 15% and 0% respectively. There were no clinical manifestations of congenital toxoplasmosis, all showed negative IgM and IgG positive 62%. In imaging tests, 5% had changed transfontanel ultrasound (49% unknown), 1% fundoscopy losses (51% ignored), and skull radiography unchanged (23% ignored). Conclusion Given the survey data, we conclude that there was poor adherence to native implementation of adequate prenatal care, underestimation of suspected cases with disabilities in serological screening, limited availability of laboratory diagnosti...