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Two infants with congenital syphilis and persistent hypoglycemia were found to have hypopituitarism. Hypopituitarism should be recognized as a potential complication of congenital syphilis; affected infants with persistent hypoglycemia should receive a prompt evaluation of pituitary function.
We report a case of severe early congenital syphilis in the infant of a mother who acquired syphilis in mid pregnancy. The mother had received full antenatal care including serological screening for syphilis. Congenital syphilis is re-emerging in a number of industrialised countries and this report demonstrates that some of the most serious cases cannot be prevented by routine antenatal screening.
Congenital syphilis was discovered in a neonate with the unusual radiographic presentation of unilateral involvement of three bones showing lytic lesions and periostitis. Congenital syphilis should be considered in a newborn infant with these radiographic manifestations, especially when a suggestive history is obtained.
Despite good prevention, congenital syphilis still occurs: the incidence in 1981-1986 was 9 in six years. In this case history an infant with osteomyelitis, due to congenital syphilis, is discussed. This article also gives a review of symptoms, diagnosis, therapy and follow-up after treatment. The best method for diagnosis is the 19S-IgM-FTA-absorption test in serum. Treatment concerns the pediatrician, as well as the orthopaedic surgeon, the neurologist, the dermatologist and the ophthalmologist, cooperating as an interdisciplinary team.
The diagnosis of congenital syphilis (CS) in newborns can only be made through a review of the mothers' testing and treatment history and through the infants' clinical and laboratory findings. We describe difficulties in the classification of CS by physicians and the health department during a recent syphilis epidemic. The records of infants identified as potential cases of CS by laboratory testing, discharge diagnosis, or health department records were reviewed by epidemiologists. The reasons for concordance and discordance in classification between the physician and the epidemiologist were determined. Congenital syphilis was identified in 126 infants. Seventeen cases were discordant and 12 cases concordant but the physician's classification was for incorrect reasons. Misclassification occurred because physicians lacked data known to the health department (n=7), health departments lacked data known to the physician (n=1), and physicians misinterpreted the case definition for CS (n=21). Suggestions for improving the diagnosis and reporting of CS are included.
The frequency of congenital syphilis continues to increase throughout the United States during the 1980s. Untreated maternal infection can lead to stillbirth, premature labor, congenital infection, and neonatal death. Preventive measures, based on control of early syphilis in women, prenatal care, improved diagnosis and diligent followup, can help to decrease the incidence of congenital syphilis. The clinical presentation and recommended regimens for therapy of the gravida with syphilis and neonates with suspected congenital syphilis are reviewed.
The serodiagnosis of congenital syphilis is reviewed. Maternal history is the least reliable criterion for detecting congenital syphilis. A positive maternal history may or may not be valid; a negative maternal history does not rule out the possibility of congenital syphilis. Syphilis serology performed on the infant is a better criterion for detecting asymptomatic congenital syphilis or delayed onset. Serial VDRL titers on the infants are the best diagnostic tool presently available. A decreasing titer indicates the presence of maternally derived antibodies. The FTA-ABS (IgM) is still not sufficiently evaluated and standardized for routine clinical application.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.