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[Acute hepatic insufficiency disclosing congenital syphilis]
Insights
Congenital syphilis can cause acute liver failure in infants, presenting with severe symptoms like jaundice and bleeding. Early penicillin treatment led to a full recovery, highlighting the importance of timely diagnosis and intervention.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hepatology
Background:
- Congenital syphilis is a serious infection transmitted from mother to child.
- Early diagnosis and treatment are crucial for preventing severe complications.
Observation:
- An infant presented with acute liver failure, jaundice, and bleeding shortly after birth.
- The infant's mother also had positive syphilis serology.
- Clinical presentation included hepatosplenomegaly, hypoglycemia, metabolic acidosis, and coagulation disturbances.
Findings:
- Serologic tests confirmed congenital syphilis in the infant and mother.
- Penicillin G therapy resulted in complete clinical recovery.
- Liver biopsy revealed residual signs of hepatitis post-treatment.
Implications:
- This case highlights congenital syphilis as a treatable cause of acute liver failure in neonates.
- Prompt recognition and treatment of congenital syphilis are vital for infant survival and long-term health.
- Highlights the importance of considering infectious etiologies in neonatal acute liver failure.
Abstract:
A breast-fed boy, born to first-cousin parents, had been vomiting since birth; his general condition remained good until age 6 weeks when vomiting became more frequent, and his status suddenly worsened, with polypnea, shock, hypothermia, jaundice, presence of blood in urine, gastric juice, stool, and bleeding tendency during veno-punctures. There was an huge hepatomegaly and a splenomegaly. Hypoglycaemia, metabolic acidosis, severe blood coagulation disturbances, elevated liver enzymes, hypoalbuminemia, pointed to an acute liver failure. He was resuscitated with current supportive measures, and was given a wide spectrum antibiotherapy. Because serologic tests for syphilis were positive in the child and his mother, including the presence of specific IgM the infant was then given Penicillin G therapy only, which resulted in a complete recovery. One month later, a needle liver biopsy showed residual signs of hepatitis. Other possible infectious or metabolic causes of acute liver failure occurring early in life had been excluded.