Congenital syphilis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]Aravind Kuchkuntla, M.B.B.S [3]

Overview

Congenital syphilis examination findings include characteristic skin rash, hepatosplenomegaly and interstitial keratitis.

Low birth weight
Presence of the signs of prematurity
Nonimmune hydrops : It is characteristic of congenital syphilis and the features of non-immune hydrops include ascites, pericardial effusion, pleural effusion and skin edema, however Rh incompatability should be ruled out as a cause of hydrops.^[1]

Vesiculobullous or maculopapular rash occurring on the palms and soles is present in 70% of the children with congenital syphilis. Other patterns of rash such as condylomata lata lesions, annular lesions, and erythema multiforme -like targetoid lesions are present in affected infants.^[2]
Later rash - copper-colored, flat or bumpy rash on the face, palms, and soles

Corneal clouding^[3]
Interstitial keratitis (IK), an inflamation of the cornea which can lead to corneal scarring and potentially blindness
Anemia
Jaundice

Snuffles, the name given to rhinitis in this situation. When chronic, this can lead to saddle nose deformity.
Rhagades, linear scars at the angles of the mouth and nose result from bacterial infection of skin lesions

Shown below is an image of Hutchinson's teeth

Hutchinson's Triad, a set of symptoms consisting of deafness, hutchinson's teeth (centrally notched, widely-spaced peg-shaped upper central incisors), and interstitial keratitis (IK), an inflamation of the cornea which can lead to corneal scarring and potentially blindness
Mulberry molars (sixth year molars with multiple poorly developed cusps)

↑ Barron SD, Pass RF (1995). "Infectious causes of hydrops fetalis". Semin Perinatol. 19 (6): 493–501. PMID 8822333.
↑ Ferreira, Sara Tavares; Correia, Cátia; Marçal, Monica; Tuna, Madalena Lopo (2016). "Skin rash: a manifestation of early congenital syphilis". BMJ Case Reports: bcr2016216148. doi:10.1136/bcr-2016-216148. ISSN 1757-790X.
↑ Ewing, C I; Roberts, C; Davidson, D C; Arya, O P (1985). "Early congenital syphilis still occurs". Archives of Disease in Childhood. 60 (12): 1128–1133. doi:10.1136/adc.60.12.1128. ISSN 0003-9888.