Congenital syphilis overview: Difference between revisions
| Line 24: | Line 24: | ||
===Physical Examination=== | ===Physical Examination=== | ||
Physical examination findings suggestive of congenital syphilis include low birth weight, signs of prematurity, skin edema, pleural effusion, vesicular skin rash, corneal clouding, jaundice and deafness. | Physical examination findings suggestive of congenital syphilis include [[low birth weight]], signs of prematurity, [[skin edema]], [[pleural effusion]], vesicular [[skin rash]], corneal clouding, [[jaundice]] and [[deafness]]. | ||
==Treatment== | ==Treatment== | ||
Revision as of 20:46, 1 March 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2] Kalsang Dolma, M.B.B.S.[3]
|
Congenital syphilis Microchapters |
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Congenital syphilis overview On the Web |
|
American Roentgen Ray Society Images of Congenital syphilis overview |
|
Risk calculators and risk factors for Congenital syphilis overview |
Overview
Congenital Syphilis is caused by Treponema pallidum, its transmitted to the fetus in utero from an infected mother via the placenta. The severity of the disease is dependent on the stage of maternal infection and the duration of exposure to the fetus. Transmission is typically in the second trimester and the highest rates of transmission are seen in women with primary syphilis. The rates of transmission decrease with the increasing duration of the maternal infection, as the concentration of spirochetes in the blood stream decreases. Syphilis infection to the fetus in utero can result in stillborn, miscarriage and a live birth with severe manifestations of hydrops. Prenatal screening for syphilis during the first trimester is recommended to all pregnant women and adequate treatment with penicillin prevents the transmission to the fetus.
Historical Perspective
Congenital syphilis was first described in an English 17th century in a pediatric textbook. Transplacental transmission from an asymptomatic infected mother was first described in 1906. Sir Jonathan Hutchinson described the triad of notched incisors, interstitial keratitis, and eighth cranial nerve deafness as a criterion for diagnosis of congenital syphilis.
Classification
Congenital syphilis can be classified into early (presenting 0-2 years) and late (greater 2 years) based upon on time of presentation. There is also a diagnostic classification of syphilis used for surveillance purpose.
Pathophysiology
Pathophysiology of congenital syphilis is still unclear.The risk of transmission to the fetus is dependent on the stage of the maternal disease (dependent on the spirochete concentration in the blood stream) and the duration of exposure to the fetus in utero.[1]The risk of vertical transmission of syphilis from an infected untreated mother decreases as maternal disease duration progresses: transmission risk of 70–100% for primary syphilis and 40% for early latent syphilis to 10% for late latent disease. The variation in the percentages with the duration of infection is due to the concentration of spirochetes in the blood stream, which decrease with the duration of maternal syphilis infection.[2]
Causes
Congenital syphilis is caused by the bacterium Treponema pallidum, which is passed from mother to child during fetal development or at birth.
Screening
Routine screening for syphilis during the antenatal period is recommended.
Diagnosis
History symptoms
Infants present with symptoms such as failure to gain weight or failure to thrive, fever, irritability, small blisters on the palms and soles, and with watery discharge from the nose.
Physical Examination
Physical examination findings suggestive of congenital syphilis include low birth weight, signs of prematurity, skin edema, pleural effusion, vesicular skin rash, corneal clouding, jaundice and deafness.
Treatment
Medical Therapy
An afflicted child can be treated using antibiotics much like an adult, however any developmental symptoms are likely to be permanent.