1/16. pituitary gland gumma in congenital syphilis after failed maternal treatment: a case report.A preterm, very low birth weight infant was born to a mother with early latent syphilis who was treated 10 days and 3 days before delivery with 2.4 mU of benzathine penicillin. The infant had clinical, laboratory, and radiographic abnormalities consistent with congenital syphilis, ie, a Venereal Disease research Laboratory test titer that was fourfold greater than was the maternal titer, hepatosplenomegaly, abnormal liver function tests, pneumonitis, osteochondritis of the long bones, and cerebrospinal fluid (CSF) examination showing a reactive Venereal Disease research Laboratory test, pleocytosis, and elevated protein content. The infant died on the third day of life, and an autopsy revealed an evolving gumma of the anterior pituitary. immunoglobulin m immunoblotting of serum and CSF was positive, and polymerase chain reaction detected treponema pallidum dna in endotracheal aspirate and CSF. This case highlights the pathologic abnormalities observed in congenital syphilis and focuses on the rare finding of an evolving anterior pituitary gumma. Furthermore, it documents the failure of maternal syphilis treatment during the last 4 weeks of pregnancy to cure fetal infection and supports the recommendation that all infants born to mothers with syphilis treated during the last 4 weeks of pregnancy should receive penicillin therapy.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/16. Pulmonary abscesses in congenital syphilis.Congenital syphilis remains a public health concern in the united states. Infants whose mothers are treated in the third trimester without adequate prenatal care have an increased risk of morbidity and mortality in the immediate perinatal period. The identification of treponema pallidum in tissue is definitive confirmation of infection. We report the case of a 32-week gestational age infant born to a mother treated for syphilis 7 days prior to delivery. The infant died 12.5 hours after birth. At autopsy, there was extensive acute hyaline membrane disease. In addition, there were bilateral pulmonary abscesses with spirochetes. The onset of maternal disease was unknown, but was probably early in or prior to the pregnancy. This is an unusual case of pulmonary involvement in congenital syphilis.- - - - - - - - - - ranking = 0.77460953753278keywords = pregnancy, gestation (Clic here for more details about this article) |
3/16. Congenital syphilis following negative antenatal screening.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.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
4/16. Congenital syphilis: unique clinical presentation in three preterm newborns.Three preterm newborns affected by congenital syphilis, born to mothers not adequately treated during pregnancy, are described. The clinical picture is characterized by a severe cholestatic hepatopathy and, in the two surviving patients, by an unusually wide ischemic-hemorrhagic lesion of the cerebral parenchyma. This lesion is probably due to a syphilitic endarteritis, and has rarely been described before in preterm infants.- - - - - - - - - - ranking = 0.5keywords = pregnancy (Clic here for more details about this article) |
5/16. Case report of an SGA infant with jaundice, direct hyperbilirubinemia, hepatosplenomegaly, thrombocytopenia, and a negative VDRL.This case report highlights the presentation of syphilis in a small-for-gestational age (SGA) female infant who was born to a mother with no prenatal care. In the first 2 days of life, the infant developed hepatosplenomegaly, conjugated hyperbilirubinemia, thrombocytopenia, and hemolysis. After extensive diagnostic investigation, the case was solved on the infant's day of life (DOL) 12. In retrospect, the health care team had obtained a diagnostic result that could potentially have solved the case on DOL 2. Although this infant suffered no long-term sequelae secondary to the delayed diagnosis, the review of this case presentation may assist other clinicians in an early identification of a potentially lethal diagnosis.- - - - - - - - - - ranking = 0.27460953753278keywords = gestation (Clic here for more details about this article) |
6/16. Congenital bilateral microphthalmos after gestational syphilis.Congenital microphthalmos and anophthalmos are currently considered rare conditions. Many infectious agents have been previously associated with these pathologies, but rarely treponema pallidum. We report a case of bilateral microphthalmos in which her mother presented gestational syphilis.- - - - - - - - - - ranking = 1.3730476876639keywords = gestation (Clic here for more details about this article) |
7/16. Failure of recommended maternal therapy to prevent congenital syphilis.A pregnant women with secondary syphilis received appropriate therapy with penicillin in the last trimester of pregnancy. At delivery, her titre had fallen fourfold, and the baby had a non-reactive cord blood titre at birth. However, the treatment failed to prevent infection in the infant, and the baby had developed signs of congenital syphilis at 10 weeks of age. The definition of "adequate therapy" of pregnant women is unclear, and recent guidelines are contradictory. Therefore, literature that pertains to penicillin therapy in pregnancy is reviewed, and new guidelines for therapy proposed.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
8/16. Identification of treponema pallidum in amniotic fluid and fetal blood from pregnancies complicated by congenital syphilis.Two pregnant women with secondary syphilis underwent amniocentesis and evaluation for fetal syphilis. In both cases, motile spirochetes, typical of treponema pallidum, were observed during dark-field microscopic examination of the amniotic fluid. The presence of T pallidum was confirmed by antitreponemal monoclonal antibody immunofluorescence assays and by rabbit infectivity tests using the amniotic fluid. In the first case, an infant at 35 weeks' gestation delivered within 24 hours of amniocentesis had hepatosplenomegaly, osteochondritis, and neurosyphilis. In the second case, a fetus at 24 weeks' gestation was hydropic and a fetal blood sample showed anemia, thrombocytopenia, and elevated liver enzymes. Fetal syphilis was confirmed by rabbit infectivity testing using fetal blood obtained by funipuncture. This is the first report of the diagnosis of fetal syphilis by funipuncture and confirmation of the presence of virulent T pallidum in the blood of a human fetus. The mother was treated for secondary syphilis, but the infant had residual signs of congenital infection at birth 14 weeks later. Neonatal serum from the first case and fetal serum from the second case showed specific immunoglobulin m reactivity with the 47-kd antigen of T pallidum by Western blot assays. A new wild-type strain of T pallidum, designated DAL-1, was isolated from the amniotic fluid of the first case and is available for future studies. We conclude that the presence of T pallidum in amniotic fluid or fetal blood indicates fetal-placental infection. Further investigation is necessary to determine the pathogenesis of amniotic fluid infection and its role in the prenatal diagnosis of congenital syphilis.- - - - - - - - - - ranking = 0.54921907506556keywords = gestation (Clic here for more details about this article) |
9/16. Congenital syphilis is with us still.A baby with neonatal congenital syphilis who was born prematurely at 33-weeks' gestation with hepatosplenomegaly, ascites and respiratory distress that was evident at birth is presented.- - - - - - - - - - ranking = 0.27460953753278keywords = gestation (Clic here for more details about this article) |
10/16. Nonsyndromatic paucity of intrahepatic bile ducts in congenital syphilis. A case report.The first case of nonsyndromatic paucity of the intrahepatic bile ducts is reported in congenital syphilis. The patient, a 2-week-old female, was born at the 31st week of gestation, weighing 1,910 g. She had a high titer of IgM antibody to treponema pallidum and sera from both parents also showed a positive reaction in the hemagglutination test for treponema pallidum. The patient had hepatosplenomegaly and increasing jaundice, and died of respiratory failure on the 70th hospital day. autopsy examination revealed paucity of the intrahepatic bile ducts, prominent giant cell transformation of hepatocytes, cholestasis and extramedullary hematopoiesis of the liver. The ratio of the number of intrahepatic bile ducts to that of the portal tracts was approximately 0.2:1. There was marked proliferation of atypical bile ductules at the margin of the portal tracts. The exact relation of this paucity to treponema pallidum remains unknown.- - - - - - - - - - ranking = 0.27460953753278keywords = gestation (Clic here for more details about this article) |
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