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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) X-ray of the lower limb (AP view) showing proximal tibial metaphyseal erosions along with periosteal reaction and (b) X-ray of the upper limb (AP view) showing distal tibial and fibular metaphyseal erosions with periosteal reaction
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Figure 2: (a) X-ray of the lower limb (AP view) showing proximal tibial metaphyseal erosions along with periosteal reaction and (b) X-ray of the upper limb (AP view) showing distal tibial and fibular metaphyseal erosions with periosteal reaction

Mentions: Laboratory evaluation revealed normocytic, normochromic anemia with hemoglobin of 5.7 g/dL, raised ESR (157 mm/h), raised C-reactive protein (132 mg/L), elevated lactate dehydrogenase levels (1607 U/L) and raised alkaline phosphatase (1472 U/L). Other blood cell counts, serum chemistry studies, coagulation studies, HIV ELISA and X-ray chest were within normal limits. Blood culture showed no growth. Ultrasonography of the abdomen revealed hepatosplenomegaly. Radiographs revealed metaphyseal erosions of the distal ends of the ulna and tibia along with periosteal reaction [Figure 2b]. The proximal tibial metaphyses revealed loss of density on the medial aspect along with periosteal reaction, suggestive of osteochondritis (Wimberger's sign). Distal metaphyses of the humerus also showed periosteal reaction [Figure 2a].


Congenital syphilis: The continuing scourge.

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

(a) X-ray of the lower limb (AP view) showing proximal tibial metaphyseal erosions along with periosteal reaction and (b) X-ray of the upper limb (AP view) showing distal tibial and fibular metaphyseal erosions with periosteal reaction
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: (a) X-ray of the lower limb (AP view) showing proximal tibial metaphyseal erosions along with periosteal reaction and (b) X-ray of the upper limb (AP view) showing distal tibial and fibular metaphyseal erosions with periosteal reaction
Mentions: Laboratory evaluation revealed normocytic, normochromic anemia with hemoglobin of 5.7 g/dL, raised ESR (157 mm/h), raised C-reactive protein (132 mg/L), elevated lactate dehydrogenase levels (1607 U/L) and raised alkaline phosphatase (1472 U/L). Other blood cell counts, serum chemistry studies, coagulation studies, HIV ELISA and X-ray chest were within normal limits. Blood culture showed no growth. Ultrasonography of the abdomen revealed hepatosplenomegaly. Radiographs revealed metaphyseal erosions of the distal ends of the ulna and tibia along with periosteal reaction [Figure 2b]. The proximal tibial metaphyses revealed loss of density on the medial aspect along with periosteal reaction, suggestive of osteochondritis (Wimberger's sign). Distal metaphyses of the humerus also showed periosteal reaction [Figure 2a].

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