Congenital syphilis physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{CMG}} {{AE}} {{KD}} | {{CMG}} {{AE}} {{KD}}{{AKI}} | ||
{{Congenital syphilis}} | {{Congenital syphilis}} | ||
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*Presence of the signs of [[prematurity]] | *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]].<ref name="pmid8822333">{{cite journal| author=Barron SD, Pass RF| title=Infectious causes of hydrops fetalis. | journal=Semin Perinatol | year= 1995 | volume= 19 | issue= 6 | pages= 493-501 | pmid=8822333 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8822333 }} </ref> | *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]].<ref name="pmid8822333">{{cite journal| author=Barron SD, Pass RF| title=Infectious causes of hydrops fetalis. | journal=Semin Perinatol | year= 1995 | volume= 19 | issue= 6 | pages= 493-501 | pmid=8822333 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8822333 }} </ref> | ||
===Skin=== | ===Skin=== | ||
* | *[[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.<ref name="FerreiraCorreia2016">{{cite journal|last1=Ferreira|first1=Sara Tavares|last2=Correia|first2=Cátia|last3=Marçal|first3=Monica|last4=Tuna|first4=Madalena Lopo|title=Skin rash: a manifestation of early congenital syphilis|journal=BMJ Case Reports|year=2016|pages=bcr2016216148|issn=1757-790X|doi=10.1136/bcr-2016-216148}}</ref> | ||
*Later rash - copper-colored, flat or bumpy rash on the face, palms, and soles | *Later rash - copper-colored, flat or bumpy rash on the face, palms, and soles | ||
===Head=== | ===Head=== | ||
*Frontal bossing | *Frontal bossing | ||
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===Eyes=== | ===Eyes=== | ||
*Corneal clouding<ref name="EwingRoberts1985">{{cite journal|last1=Ewing|first1=C I|last2=Roberts|first2=C|last3=Davidson|first3=D C|last4=Arya|first4=O P|title=Early congenital syphilis still occurs.|journal=Archives of Disease in Childhood|volume=60|issue=12|year=1985|pages=1128–1133|issn=0003-9888|doi=10.1136/adc.60.12.1128}}</ref> | *Corneal clouding<ref name="EwingRoberts1985">{{cite journal|last1=Ewing|first1=C I|last2=Roberts|first2=C|last3=Davidson|first3=D C|last4=Arya|first4=O P|title=Early congenital syphilis still occurs.|journal=Archives of Disease in Childhood|volume=60|issue=12|year=1985|pages=1128–1133|issn=0003-9888|doi=10.1136/adc.60.12.1128}}</ref> | ||
*Interstitial [[keratitis]] (IK), an inflamation of the [[cornea]] which can lead to corneal scarring and potentially [[blindness]] | *Interstitial [[keratitis]] (IK), an inflamation of the [[cornea]] which can lead to corneal scarring and potentially [[blindness]] | ||
*[[Anemia]] | *[[Anemia]] | ||
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Shown below is an image of Hutchinson's teeth | Shown below is an image of Hutchinson's teeth | ||
[[Image:Hutchinson_teeth_congenital_syphilis_PHIL_2385.rsh.jpg| | [[Image:Hutchinson_teeth_congenital_syphilis_PHIL_2385.rsh.jpg|200px|thumb|center|By CDC/Susan Lindsley - http://phil.cdc.gov/phil_images/20021114/34/PHIL_2385_lores.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=2134349]] | ||
*Hutchinson's Triad, a set of symptoms consisting of [[deafness]], [[ | *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) | *Mulberry [[molars]] (sixth year molars with multiple poorly developed cusps) | ||
| Line 42: | Line 43: | ||
*[[Enlarged spleen]] | *[[Enlarged spleen]] | ||
===Extremities=== | ===Extremities=== | ||
*Sabre [[shin]]s: | *Sabre [[shin]]s: sharp-edged anteriorly convex [[tibia]] | ||
*[[lymphadenopathy|Lymph node enlargement]] | *[[lymphadenopathy|Lymph node enlargement]] | ||
*Pseudoparalysis | *Pseudoparalysis | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category:Neonatology]] | [[Category:Neonatology]] | ||
[[Category:Needs overview]] | [[Category:Needs overview]] | ||
[[Category:Emergency medicine]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Obstetrics]] | |||
Latest revision as of 21:04, 29 July 2020
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]
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Overview
Congenital syphilis examination findings include characteristic skin rash, hepatosplenomegaly and interstitial keratitis.
Physical Examination
General Appearance
- 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]
Skin
- 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
Head
- Frontal bossing
- Poorly developed maxillae
Eyes
- Corneal clouding[3]
- Interstitial keratitis (IK), an inflamation of the cornea which can lead to corneal scarring and potentially blindness
- Anemia
- Jaundice
Ears
Nose
- 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
Throat
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)
Abdomen
Extremities
- Sabre shins: sharp-edged anteriorly convex tibia
- Lymph node enlargement
- Pseudoparalysis
References
- ↑ 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.