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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

X-rays of (a) lower limbs (AP view) and (b) upper limbs (AP view) showing resolution of metaphyseal erosions and periosteal reaction
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Figure 3: X-rays of (a) lower limbs (AP view) and (b) upper limbs (AP view) showing resolution of metaphyseal erosions and periosteal reaction

Mentions: Based on the clinical manifestations along with pseudoparalysis, typical radiological findings of osteochondritis, positive VDRL and TPHA tests, a diagnosis of early congenital syphilis was made. The infant was managed with intravenous aqueous Crystalline Penicillin G 50,000 units/kg every 4 hours a day for a total of 10 days. The condition of the child started improving after 5-6 days of infusion. Both the parents were diagnosed as latent syphilis of unknown duration and were administered Benzathine Penicillin G 7.2 million units total, administered as three doses of 2.4 million units IM each at 1-week intervals. Repeat VDRL titers of the child 3 months after penicillin infusion showed a four-fold decrease and repeat radiographs of the child showed completed resolution of erosions and periosteal reaction [Figure 3a and b].


Congenital syphilis: The continuing scourge.

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

X-rays of (a) lower limbs (AP view) and (b) upper limbs (AP view) showing resolution of metaphyseal erosions and periosteal reaction
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: X-rays of (a) lower limbs (AP view) and (b) upper limbs (AP view) showing resolution of metaphyseal erosions and periosteal reaction
Mentions: Based on the clinical manifestations along with pseudoparalysis, typical radiological findings of osteochondritis, positive VDRL and TPHA tests, a diagnosis of early congenital syphilis was made. The infant was managed with intravenous aqueous Crystalline Penicillin G 50,000 units/kg every 4 hours a day for a total of 10 days. The condition of the child started improving after 5-6 days of infusion. Both the parents were diagnosed as latent syphilis of unknown duration and were administered Benzathine Penicillin G 7.2 million units total, administered as three doses of 2.4 million units IM each at 1-week intervals. Repeat VDRL titers of the child 3 months after penicillin infusion showed a four-fold decrease and repeat radiographs of the child showed completed resolution of erosions and periosteal reaction [Figure 3a and b].

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