Article: Clinically Confirmed Congenital Rubella Syndrome: The Role of Echocardiography

Background: Congenital rubella syndrome (CRS) affects thousands of children in the developing world because rubella vaccination is not routinely available in most of these countries. Among its many manifestations, congenital heart disease is life threatening.

Case Details: A 9-month-old infant presented with whitish lesions over her left eye. She was evaluated with echocardiography that revealed peripheral pulmonary stenosis and patent ductus arteriosus. She had severe acute malnutrition and clinically confirmed congenital rubella syndrome (CRS). There was no available serologic test to confirm the diagnosis.

Conclusion: This case was presented to demonstrate typical dual features of CRS by echocardiography and to emphasize the benefit of vaccination to prevent deleterious complications from congenital rubella syndrome.

Citing Articles

Anesthetic considerations in an adult congenital rubella syndrome-patent ductus arteriosus ligation in a resource-limited setting.

Pruthi G, Gupta M, Garg B, Grewal A Ann Card Anaesth. 2023; 26(4):469-471.

PMID: 37861590 PMC: 10691570. DOI: 10.4103/aca.aca_46_23.

Maternal paracetamol intake and fetal ductus arteriosus constriction/closure: comprehensive signal evaluation using the Austin Bradford Hill criteria.

Hauben M, Bai S, Hung E, Lobello K, Tressler C, Zucal V Eur J Clin Pharmacol. 2021; 77(7):1019-1028.

PMID: 33410971 DOI: 10.1007/s00228-020-03039-z.

Hospital based surveillance of congenital rubella syndrome cases in the pre-vaccine era in Amhara Regional State, Ethiopia: A base line information for the country.

Wondimeneh Y, Tiruneh M, Ferede G, Denekew K, Admassu F, Tessema B PLoS One. 2018; 13(11):e0207095.

PMID: 30419036 PMC: 6231648. DOI: 10.1371/journal.pone.0207095.

References

1.

Deb A, Ubil E . Cardiac fibroblast in development and wound healing. J Mol Cell Cardiol. 2014; 70:47-55. PMC: 4028446. DOI: 10.1016/j.yjmcc.2014.02.017. View

2.

Maroto E, Fouron J, Ake E, van Doesburg N, Cartwright D, Teyssier G . Closure of the ductus arteriosus: determinant factor in the appearance of transient peripheral pulmonary stenosis of the neonate. J Pediatr. 1991; 119(6):955-9. DOI: 10.1016/s0022-3476(05)83055-0. View

3.

MICHAELS R, KENNY F . Postnatal growth retardation in congenital rubella. Pediatrics. 1969; 43(2):251-9. View

4.

Pettersen M, Du W, Skeens M, Humes R . Regression equations for calculation of z scores of cardiac structures in a large cohort of healthy infants, children, and adolescents: an echocardiographic study. J Am Soc Echocardiogr. 2008; 21(8):922-34. DOI: 10.1016/j.echo.2008.02.006. View

5.

Grant G, Reef S, Dabbagh A, Gacic-Dobo M, Strebel P . Global Progress Toward Rubella and Congenital Rubella Syndrome Control and Elimination - 2000-2014. MMWR Morb Mortal Wkly Rep. 2015; 64(37):1052-5. DOI: 10.15585/mmwr.mm6437a5. View

6.

Lazar M, Perelygina L, Martines R, Greer P, Paddock C, Peltecu G . Immunolocalization and Distribution of Rubella Antigen in Fatal Congenital Rubella Syndrome. EBioMedicine. 2016; 3:86-92. PMC: 4739417. DOI: 10.1016/j.ebiom.2015.11.050. View

7.

Oster M, Riehle-Colarusso T, Correa A . An update on cardiovascular malformations in congenital rubella syndrome. Birth Defects Res A Clin Mol Teratol. 2009; 88(1):1-8. DOI: 10.1002/bdra.20621. View

8.

CHESS S, Fernandez P . Impulsivity in rubella deaf children: a longitudinal study. Am Ann Deaf. 1980; 125(4):505-9. DOI: 10.1353/aad.2012.1329. View

9.

Chen Z, Chen L, Wu L . Transcatheter amplatzer occlusion and surgical closure of patent ductus arteriosus: comparison of effectiveness and costs in a low-income country. Pediatr Cardiol. 2009; 30(6):781-5. DOI: 10.1007/s00246-009-9440-3. View

10.

Danilowicz D, Rudolph A, Hoffman J, Heymann M . Physiologic pressure differences between main and branch pulmonary arteries in infants. Circulation. 1972; 45(2):410-9. DOI: 10.1161/01.cir.45.2.410. View

11.

Cooper L, Ziring P, Ockerse A, Fedun B, Kiely B, Krugman S . Rubella. Clinical manifestations and management. Am J Dis Child. 1969; 118(1):18-29. View

12.

Rodriguez R, Riggs T . Physiologic peripheral pulmonic stenosis in infancy. Am J Cardiol. 1990; 66(20):1478-81. DOI: 10.1016/0002-9149(90)90538-c. View