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Congenital syphilis and necrotizing funisitis

R M Fojaco1, G T Hensley, L Moskowitz

  • 1University of Miami/Jackson Memorial Medical Center, Department of Pathology, FL 33101.

JAMA
|March 24, 1989
PubMed

Insights

Necrotizing funisitis, an umbilical cord inflammation, was exclusively linked to syphilis in 16 cases over 5 years. This finding, supported by historical literature, aids in diagnosing congenital syphilis at birth via the "barberpole" cord appearance.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatology
  • Infectious Diseases

Background:

  • Necrotizing funisitis is a deep inflammatory process affecting the umbilical cord matrix.
  • Previous understanding did not strongly associate this condition with specific infections.

Purpose of the Study:

  • To investigate the association between necrotizing funisitis and infectious agents.
  • To determine if necrotizing funisitis can serve as a diagnostic marker for congenital syphilis.

Main Methods:

  • Retrospective review of 16 cases of necrotizing funisitis over a 5-year period.
  • Analysis of associated maternal and congenital infections.
  • Comparison with historical medical literature on funisitis and syphilis.

Main Results:

  • All 16 identified cases of necrotizing funisitis were associated with maternal and congenital syphilis.
  • No other infections were found to be associated with necrotizing funisitis during the study period.
  • Historical literature confirms syphilis as a specific cause of deep funisitis with angiophlebitis.

Conclusions:

  • Necrotizing funisitis is strongly associated with syphilis, suggesting a specific etiological link.
  • The characteristic "barberpole" umbilical cord appearance in necrotizing funisitis can facilitate presumptive diagnosis of congenital syphilis at birth.

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