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Congenital syphilis: The continuing scourge.

Agrawal PG, Joshi R, Kharkar VD, Bhaskar MV - Indian J Sex Transm Dis (2014 Jul-Dec)

Bottom Line: However, its early diagnosis is often difficult because more than half of the affected infants are asymptomatic, and the signs in symptomatic infants may be subtle and nonspecific.Although its incidence is declining, this long-forgotten disease continues to affect pregnant women, resulting in considerable perinatal morbidity and mortality.We hereby report a case of a 2-month-old infant with early congenital syphilis presenting with joint swellings and Parrot's pseudoparalysis, a comparative rarity in the present scenario.

View Article: PubMed Central - PubMed

Affiliation: Department of Skin and VD, Gordhandas Sunderdas Medical College and King Edward Memorial Hospital (GSMC and KEMH), Mumbai, Maharashtra, India.

ABSTRACT
Congenital syphilis is a severe, disabling infection that occurs due to the transmission of Treponema pallidum across the placenta during pregnancy or from contact with an infectious genital lesion during delivery. However, its early diagnosis is often difficult because more than half of the affected infants are asymptomatic, and the signs in symptomatic infants may be subtle and nonspecific. Although its incidence is declining, this long-forgotten disease continues to affect pregnant women, resulting in considerable perinatal morbidity and mortality. We hereby report a case of a 2-month-old infant with early congenital syphilis presenting with joint swellings and Parrot's pseudoparalysis, a comparative rarity in the present scenario. The report also stresses upon the importance of implementing the Centres for Disease Control and Prevention recommendation that all the pregnant women should be screened for syphilis in the first antenatal visit in the first trimester and again in late pregnancy.

No MeSH data available.


Related in: MedlinePlus

(a) Swelling of the right wrist joint and (b) swelling of bilateral knee joints
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Figure 1: (a) Swelling of the right wrist joint and (b) swelling of bilateral knee joints

Mentions: A 2-month-old full-term female infant, born by elective lower section caesarean section, second by birth order, presented with complaints of restricted movements of her upper extremities along with swelling of the wrist joints and knee joints and mild fever since 20 days. She had an unremarkable neonatal course with no history of trauma, bleeding, seizures or altered sensorium. Examination revealed a swelling with no warmth or erythema of the bilateral wrist and knee joints along with marked paucity of spontaneous movements [Figure 1a and b]. The infant cried on passive movement of the joints. There was mild pallor and hepatosplenomegaly, with no icterus, lymphadenopathy, snuffles, feeding difficulty, rash, bulging anterior fontanel or cranial nerve palsy. The mother had an uneventful pregnancy with negative VDRL test and enzyme-linked immunosorbent assay (ELISA) for HIV at 20 weeks of gestation. Her examination was noncontributory and her previous child was healthy. Based on the clinical presentation, a differential diagnosis of pseudoparalysis secondary to septic arthritis, scurvy or congenital syphilis was considered. The child was administered intravenous Ceftriaxone empirically along with multivitamins, but showed only mild improvement in her condition.


Congenital syphilis: The continuing scourge.

Agrawal PG, Joshi R, Kharkar VD, Bhaskar MV - Indian J Sex Transm Dis (2014 Jul-Dec)

(a) Swelling of the right wrist joint and (b) swelling of bilateral knee joints
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553844&req=5

Figure 1: (a) Swelling of the right wrist joint and (b) swelling of bilateral knee joints
Mentions: A 2-month-old full-term female infant, born by elective lower section caesarean section, second by birth order, presented with complaints of restricted movements of her upper extremities along with swelling of the wrist joints and knee joints and mild fever since 20 days. She had an unremarkable neonatal course with no history of trauma, bleeding, seizures or altered sensorium. Examination revealed a swelling with no warmth or erythema of the bilateral wrist and knee joints along with marked paucity of spontaneous movements [Figure 1a and b]. The infant cried on passive movement of the joints. There was mild pallor and hepatosplenomegaly, with no icterus, lymphadenopathy, snuffles, feeding difficulty, rash, bulging anterior fontanel or cranial nerve palsy. The mother had an uneventful pregnancy with negative VDRL test and enzyme-linked immunosorbent assay (ELISA) for HIV at 20 weeks of gestation. Her examination was noncontributory and her previous child was healthy. Based on the clinical presentation, a differential diagnosis of pseudoparalysis secondary to septic arthritis, scurvy or congenital syphilis was considered. The child was administered intravenous Ceftriaxone empirically along with multivitamins, but showed only mild improvement in her condition.

Bottom Line: However, its early diagnosis is often difficult because more than half of the affected infants are asymptomatic, and the signs in symptomatic infants may be subtle and nonspecific.Although its incidence is declining, this long-forgotten disease continues to affect pregnant women, resulting in considerable perinatal morbidity and mortality.We hereby report a case of a 2-month-old infant with early congenital syphilis presenting with joint swellings and Parrot's pseudoparalysis, a comparative rarity in the present scenario.

View Article: PubMed Central - PubMed

Affiliation: Department of Skin and VD, Gordhandas Sunderdas Medical College and King Edward Memorial Hospital (GSMC and KEMH), Mumbai, Maharashtra, India.

ABSTRACT
Congenital syphilis is a severe, disabling infection that occurs due to the transmission of Treponema pallidum across the placenta during pregnancy or from contact with an infectious genital lesion during delivery. However, its early diagnosis is often difficult because more than half of the affected infants are asymptomatic, and the signs in symptomatic infants may be subtle and nonspecific. Although its incidence is declining, this long-forgotten disease continues to affect pregnant women, resulting in considerable perinatal morbidity and mortality. We hereby report a case of a 2-month-old infant with early congenital syphilis presenting with joint swellings and Parrot's pseudoparalysis, a comparative rarity in the present scenario. The report also stresses upon the importance of implementing the Centres for Disease Control and Prevention recommendation that all the pregnant women should be screened for syphilis in the first antenatal visit in the first trimester and again in late pregnancy.

No MeSH data available.


Related in: MedlinePlus