ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Clinical manifestations of early congenital syphilis*

Clinical manifestations of early congenital syphilis*
Gestational/perinatal
Stillbirth  
Prematurity  
Birth weight <2500 g  
Nonimmune hydrops fetalis  
Placenta Large, thick, pale (send for pathologic/histologic evaluation)
Umbilical cord Inflamed with abscess-like foci of necrosis within Wharton's jelly, centered around the umbilical vessels (necrotizing funisitis); barber-pole appearance (send for pathologic/histologic evaluation)
Systemic
Fever May be more prominent in infants born to mothers who are affected late in pregnancy and whose serology is negative at delivery
Hepatomegaly Splenomegaly occurs in approximately one-half of patients with hepatomegaly—isolated splenomegaly does not occur
Generalized lymphadenopathy May be as large as 1 cm; generally nontender and firm
Failure to thrive  
Edema Due to anemia/hydrops fetalis, nephrotic syndrome, malnutrition
Mucocutaneous
Syphilitic rhinitis ("snuffles") Can be an early feature, developing after the first week of life; contains spirochetes and is infectious (use contact precautions)
Maculopapular rash Usually appears one to two weeks after rhinitis. Oval lesions, initially red or pink and then coppery brown; may be associated with superficial desquamation or scaling, particularly on the palms or soles; more common on the buttocks, back, posterior thighs, and soles; contains spirochetes and is infectious (use contact precautions).
Vesicular rash (pemphigus syphiliticus) May be present at birth, most often develops in first four weeks; widely disseminated; vesicular fluid contains spirochetes and is infectious (use contact precautions)
Condylomata lata Single or multiple, flat, wartlike, moist lesions around the mouth, nares, and anus and other areas of the skin where there is moisture or friction; lesions contain spirochetes and are infectious (use contact precautions); frequently present without other signs of infection
Jaundice Hyperbilirubinemia secondary to syphilitic hepatitis and/or hemolysis
Hematologic
Anemia

Newborn period: Hemolytic (Coomb's test [direct antiglobulin test] negative); may persist after effective treatment

After one month of age: May be chronic and nonhemolytic
Thrombocytopenia May be associated with bleeding or petechiae; can be the only manifestation of congenital infection
Leukopenia  
Leukocytosis  
Musculoskeletal
Pseudoparalysis of Parrot Lack of movement of an extremity because of pain associated with bone lesion; affects upper extremities more often than lower; usually unilateral; rarely present at birth; poorly correlated with radiographic abnormalities
Radiographic abnormalities: Most frequent abnormality in untreated early congenital syphilis; not usually clinically discernible; typically multiple and symmetric
Periostitis Irregular periosteal thickening; usually present at birth, but may appear in the first few weeks of life
Wegner sign Metaphyseal serration or "sawtooth metaphysis"
Wimberger sign Demineralization and osseous destruction of the upper medial tibial
Neurologic
CSF abnormalities Reactive CSF VDRL; elevated CSF white blood cell count; elevated CSF protein
Acute syphilitic leptomeningitis Onset during the first year of life, usually between 3 and 6 months; presentation similar to bacterial meningitis but CSF findings more consistent with aseptic meningitis (mononuclear predominance); responds to penicillin therapy
Chronic meningovascular syphilis Onset toward the end of the first year; hydrocephalus; cranial nerve palsies; intellectual/neurodevelopmental deterioration; cerebral infarction; protracted course
Miscellaneous
Pneumonia/pneumonitis/respiratory distress Complete opacification of both lung fields on chest radiograph
Nephrotic syndrome Usually occurs at two to three months of age and manifests with generalized edema and ascites
CSF: cerebrospinal fluid; VDRL: Venereal Disease Research Laboratory test.
* All of these findings may occur in other congenital infections; none is specific for congenital syphilis.
Data from:
  1. Ingall D, Sanchez PJ, Baker CH. Syphilis. In: Infectious Diseases of the Fetus and Newborn infant, 6th edition, Remington JS, Klein JO, Wilson CB, Baker CJ (Eds), Elsevier Saunders, Philadelphia 2006. p.545.
  2. Dobson SR, Sanchez PJ. Syphilis. In: Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 7th, Cherry JD, Harrison GJ, Kaplan SL, et al. (Eds), Elsevier Saunders, Philadelphia 2014. p.1761.
  3. Woods CR. Syphilis in children: congenital and acquired. Semin Pediatr Infect Dis 2005; 16:245.
  4. Saloojee H, Velaphi S, Goga Y, et al. The prevention and management of congenital syphilis: an overview and recommendations. Bull World Health Organ 2004; 82:424.
  5. Chakraborty R, Luck S. Syphilis is on the increase: the implications for child health. Arch Dis Child 2008; 93:105.
  6. Rawstron SA. Treponema pallidum (Syphilis). In: Principles and Practice of Pediatric Infectious Diseases, 3rd edition, Long SS, Pickering LK, Prober CG (Eds), Churchill Livingstone Elsevier, Philadelphia 2008. p.930.
Graphic 67809 Version 8.0

آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟