Alexandra K. Medoro, MD, an attending physician with the Division of Neonatology and Division of Infectious Diseases at Children's Hospital of Philadelphia (CHOP), leads the Congenital and Perinatal Infections Clinic (CPIC). The CPIC serves as a dedicated resource for newborns diagnosed with congenital or perinatal infections, ensuring comprehensive follow-up care and support. In this Q-and-A, Dr. Medoro discusses the clinic’s mission, services, and the critical role it plays in supporting infants and their families.
Q: What was the motivation behind establishing the Congenital and Perinatal Infections Clinic at CHOP?
Dr. Medoro: We saw a clear need for a clinical center for infants diagnosed with congenital and perinatal infections. Conditions like congenital cytomegalovirus (CMV) can lead to hearing loss, neurodevelopmental challenges, and other health issues. Without dedicated follow-up care, these infants can get lost in the transition from the hospital to outpatient care. Our clinic acts as a bridge, providing continuous support and multidisciplinary care to ensure these children receive the specialized care they need.
Q: What are the primary conditions the CPIC focuses on?
Dr. Medoro: Our clinic primarily manages congenital CMV, congenital syphilis, congenital toxoplasmosis, and perinatal herpes simplex virus (HSV) infections. We also evaluate and treat infants with suspected congenital infections or other perinatal infectious concerns. Many of these infections can have long-term effects on hearing, vision and neurological development, which makes timely diagnosis and intervention critical.
Q: How does the clinic ensure a smooth transition from the hospital to outpatient care?
Dr. Medoro: We prioritize early intervention. After a referral, our nursing team quickly reviews the infant’s birth records to coordinate an expedited appointment. In some cases, we offer telemedicine visits to promptly address family concerns and initiate necessary evaluations. Early diagnosis allows us to start antiviral therapies when appropriate, which can prevent or reduce hearing loss and other complications.
Q: What specialists are involved in patient care at CPIC?
Dr. Medoro: While our infectious disease group leads the clinic, we collaborate closely with specialists from ophthalmology, audiology, neurology, ear, nose and throat (ENT), and neurodevelopmental care. We also connect families to services such as speech therapy, occupational therapy and physical therapy, as needed.
Q: How are infants referred to the clinic?
Dr. Medoro: Referrals typically come from neonatologists, pediatricians or other specialists. For example, a baby may not pass their newborn hearing screening, prompting further testing for CMV. In Pennsylvania, newborns who fail the hearing test are recommended to undergo CMV testing. Pediatricians may also refer infants with signs such as low platelets, small head circumference, or other abnormalities suggesting a congenital infection.
Q: What diagnostic tests and treatments are available for these infants?
Dr. Medoro: Diagnostics include blood, urine and saliva tests to confirm infection. We also perform head imaging like MRIs, as well as hearing tests and eye exams to assess the extent of infection. Treatment options range from short courses of antimicrobial medications to year-long therapies, depending on the infection. For example, some infants with CMV can be treated with antiviral medications to mitigate the risk of hearing loss.
Q: How does the clinic support families in managing long-term complications?
Dr. Medoro: Our clinic offers ongoing care and monitoring, typically seeing infants every couple of months during their first year of life. We track developmental milestones and perform regular hearing and vision assessments. Additionally, we provide counseling and education to help families navigate the uncertainties of their child’s diagnosis. One of our goals as the clinic grows is to expand support services, including hiring a dedicated social worker and incorporating neurodevelopmental screenings on-site.
Q: What resources does CPIC offer to parents?
Dr. Medoro: Education is a cornerstone of our clinic. Many families are unfamiliar with congenital infections, so we provide comprehensive information tailored to their child’s diagnosis. We’re also developing educational materials, including brochures, and offer ongoing support to address families' concerns. Our role also extends to educating referring providers who may not be as experienced in managing these infections.
Q: What do you hope to achieve with the CPIC?
Dr. Medoro: Our ultimate goal is to provide comprehensive, compassionate care that gives families confidence and clarity during a challenging time. By offering timely diagnosis, effective treatments, and long-term follow-up, we aim to optimize outcomes for these children. Additionally, we’re committed to expanding our services to meet the evolving needs of our patients and their families.
For more information about the Congenital and Perinatal Infections Clinic at CHOP, call 267-425-3377.
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Alexandra K. Medoro, MD, an attending physician with the Division of Neonatology and Division of Infectious Diseases at Children's Hospital of Philadelphia (CHOP), leads the Congenital and Perinatal Infections Clinic (CPIC). The CPIC serves as a dedicated resource for newborns diagnosed with congenital or perinatal infections, ensuring comprehensive follow-up care and support. In this Q-and-A, Dr. Medoro discusses the clinic’s mission, services, and the critical role it plays in supporting infants and their families.
Q: What was the motivation behind establishing the Congenital and Perinatal Infections Clinic at CHOP?
Dr. Medoro: We saw a clear need for a clinical center for infants diagnosed with congenital and perinatal infections. Conditions like congenital cytomegalovirus (CMV) can lead to hearing loss, neurodevelopmental challenges, and other health issues. Without dedicated follow-up care, these infants can get lost in the transition from the hospital to outpatient care. Our clinic acts as a bridge, providing continuous support and multidisciplinary care to ensure these children receive the specialized care they need.
Q: What are the primary conditions the CPIC focuses on?
Dr. Medoro: Our clinic primarily manages congenital CMV, congenital syphilis, congenital toxoplasmosis, and perinatal herpes simplex virus (HSV) infections. We also evaluate and treat infants with suspected congenital infections or other perinatal infectious concerns. Many of these infections can have long-term effects on hearing, vision and neurological development, which makes timely diagnosis and intervention critical.
Q: How does the clinic ensure a smooth transition from the hospital to outpatient care?
Dr. Medoro: We prioritize early intervention. After a referral, our nursing team quickly reviews the infant’s birth records to coordinate an expedited appointment. In some cases, we offer telemedicine visits to promptly address family concerns and initiate necessary evaluations. Early diagnosis allows us to start antiviral therapies when appropriate, which can prevent or reduce hearing loss and other complications.
Q: What specialists are involved in patient care at CPIC?
Dr. Medoro: While our infectious disease group leads the clinic, we collaborate closely with specialists from ophthalmology, audiology, neurology, ear, nose and throat (ENT), and neurodevelopmental care. We also connect families to services such as speech therapy, occupational therapy and physical therapy, as needed.
Q: How are infants referred to the clinic?
Dr. Medoro: Referrals typically come from neonatologists, pediatricians or other specialists. For example, a baby may not pass their newborn hearing screening, prompting further testing for CMV. In Pennsylvania, newborns who fail the hearing test are recommended to undergo CMV testing. Pediatricians may also refer infants with signs such as low platelets, small head circumference, or other abnormalities suggesting a congenital infection.
Q: What diagnostic tests and treatments are available for these infants?
Dr. Medoro: Diagnostics include blood, urine and saliva tests to confirm infection. We also perform head imaging like MRIs, as well as hearing tests and eye exams to assess the extent of infection. Treatment options range from short courses of antimicrobial medications to year-long therapies, depending on the infection. For example, some infants with CMV can be treated with antiviral medications to mitigate the risk of hearing loss.
Q: How does the clinic support families in managing long-term complications?
Dr. Medoro: Our clinic offers ongoing care and monitoring, typically seeing infants every couple of months during their first year of life. We track developmental milestones and perform regular hearing and vision assessments. Additionally, we provide counseling and education to help families navigate the uncertainties of their child’s diagnosis. One of our goals as the clinic grows is to expand support services, including hiring a dedicated social worker and incorporating neurodevelopmental screenings on-site.
Q: What resources does CPIC offer to parents?
Dr. Medoro: Education is a cornerstone of our clinic. Many families are unfamiliar with congenital infections, so we provide comprehensive information tailored to their child’s diagnosis. We’re also developing educational materials, including brochures, and offer ongoing support to address families' concerns. Our role also extends to educating referring providers who may not be as experienced in managing these infections.
Q: What do you hope to achieve with the CPIC?
Dr. Medoro: Our ultimate goal is to provide comprehensive, compassionate care that gives families confidence and clarity during a challenging time. By offering timely diagnosis, effective treatments, and long-term follow-up, we aim to optimize outcomes for these children. Additionally, we’re committed to expanding our services to meet the evolving needs of our patients and their families.
For more information about the Congenital and Perinatal Infections Clinic at CHOP, call 267-425-3377.
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