Related Experiment Videos
Chest radiographs of neonates with respiratory failure caused by congenital syphilis
C H Pieper1, W F van Gelderen, J Smith
1Department of Pediatrics, University of Stellenbosch, Republic of South Africa.
Insights
Congenital syphilis in newborns causes respiratory failure, necessitating intensive care. Radiographic findings, including nodular patterns and bone changes, aid in early diagnosis of syphilitic pneumonitis.
Area of Science:
- Neonatal care
- Pediatric radiology
- Infectious diseases
Background:
- Congenital syphilis incidence is rising, particularly in developing nations.
- This increase leads to more neonates requiring intensive care for respiratory failure due to syphilitic pneumonitis.
- Early diagnosis is crucial for timely and effective treatment.
Purpose of the Study:
- To describe the radiographic features of congenital syphilitic pneumonitis in neonates.
- To compare the radiographic findings in neonates with congenital syphilis to those with other causes of respiratory distress.
- To evaluate the diagnostic accuracy of radiography for congenital syphilitic pneumonitis.
Main Methods:
- Retrospective analysis of chest radiographs from 20 neonates with congenital syphilis requiring mechanical ventilation.
- Comparison with radiographs of 20 neonates with non-syphilitic respiratory distress.
- Assessment of characteristic radiographic patterns and bony involvement.
Main Results:
- A coarse nodular pattern with band-like opacities was observed in 17/20 neonates with congenital syphilis.
- Nodular opacities became confluent on follow-up.
- Radiographic changes typical of congenital syphilis were present in the proximal humeri of 13/20 cases.
- Radiographic diagnosis showed 75% sensitivity and specificity.
Conclusions:
- Congenital syphilitic pneumonitis presents with distinctive radiographic findings, including interstitial patterns and bony abnormalities.
- Chest radiography is a valuable tool for suspecting congenital syphilitic pneumonitis.
- Congenital syphilitic pneumonitis should be considered in the differential diagnosis of neonatal respiratory distress with interstitial patterns.
Abstract:
Congenital syphilis still occurs in newborn babies and the prevalence has increased in recent years, especially in developing countries. This has led to an increase in the number of babies with congenital syphilis requiring intensive care for respiratory failure. The early recognition of this disease could lead to the institution of timely and appropriate treatment. In this study the radiological picture of syphilitic pneumonitis is described in 20 neonates admitted to our neonatal intensive care unit requiring ventilation for respiratory failure. The radiological picture of the babies with syphilis was compared to 20 babies with other causes of respiratory distress. The radiological picture in 17 babies demonstrated a coarse nodular pattern in addition to band-like opacities radiating from the hilar regions. The nodular opacities became confluent on follow-up radiographs. In 13 cases, the proximal humeri showed changes typical of congenital syphilis. Two of the three babies with syphilis who did not have the typical chest radiological picture had bony involvement visible on the chest radiograph. Both the sensitivity and specificity of radiographic diagnosis were 75% with a positive and negative predictive value of 75%. The diagnosis of congenital syphilitic pneumonitis can therefore be suspected on chest radiographs and should be included in the differential diagnosis of any baby who presents with an interstitial pattern on chest radiography.