Congenital syphilis

Syphilis, caused by the spirochete Treponema pallidum, can have numerous and complex manifestations. Clinician familiarity, stage-specific diagnosis, and effective treatment are vital. Missed or inappropriately treated syphilis may result in cardiovascular complications, neurologic disease, or congenital syphilis. 

Congenital syphilis is a condition in which the fetus is infected with T. pallidum as a result of the hematogenous spread from an infected mother, although transmission may also occur from direct contact with the infectious genitalia of the mother. Since the primary stage of syphilis is characterized by spirochetemia, infectious rates of the fetus are nearly 100% if the mother has primary syphilis.11... 

Peeling R, Ye H. Diagnostic tools for preventing and managing maternal and congenital syphilis an overview. Bull World Health Organ 2004 82 439M46. 

This scenario is based on a true story that demonstrates the multiple breakdowns that can occur during the medication use process that led to the death of an infant. An infant was born to a mother with a prior history of syphilis. Despite having incomplete patient information about the mothers past treatment for syphilis and the current status of both the mother and the child, a decision was made to treat the infant for congenital syphilis. After phone consultation with infectious disease specialists and the health department, an order was written for one dose of benzathine penicillin G 150,000 units IM. ... 

The physicians, nurses, and pharmacists, unfamiliar with the treatment of congenital syphilis, also had limited knowledge about this medication. The pharmacist consulted Drug Facts and Comparisons to determine the usual dose of penicillin G benzathine for an infant. However, she misread the dose as... 

Congenital syphilis Bilateral Diffuse Deep, profound Iritis, edema systemic... 

Virus infections Viral cholangiopathy, sometimes with concomitant destruction of the intrahepatic bile ducts, has been reported to derive from several species of viruses, e.g. HIV, cytomegaly, rotaviruses, respiratory syncitial virus (RS), hepatitis C, congenital rubella and reovirus 1 Bacteria may, however, also be the cause of disease, as is the case with congenital syphilis. 

Some of the most serious sequelae of STDs are associated with congenital or perinatal infections. Most neonatal infections are acquired at birth, after infant passage through an infected cervix or vagina. Neonatal Chlamydia trachomatis, Neisseria gonorrhoeae, and herpes simplex virus (HSV) infections are associated with this type of spread. For pregnant women with syphilis, infection is usu-... 

Guarner J, Greer PW, Bartlett J, et al. Congenital syphilis in a newborn an immunopathologic study. Mod Pathol. 1999 12 82-87. 

Infants with congenital syphilis discovered at birth or during the postnatal period should be treated for at least 10 days with 50,000 units per kg daily of aqueous penicillin G in two divided doses or 50,000 units per kg of procaine penicillin Gina single daily dose. 

Congenital syphilis Syphilis passed to a fetus when treponemes cross the placenta from mother to child before birth. 

Interstitial infiltration in congenital syphilis Gumma in tertiary or acquired syphilis... 

Finally, appropriate studies will serve to distinguish congenital syphilis, lymphogranulomatosis, Banti-syndrome and portal vein thrombosis. 

MGN may be primary or secondary to other conditions (e.g., hepatitis B, malaria, congenital syphilis, SEE, drugs, and neoplasms). The latter cases predominate in children (Cameron 1990). Clinical presentation is with NS and microhaematuria... 

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