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Congenital syphilis: report of twelve cases
1Department of Pediatrics, Taichung Veterans General Hospital, Taiwan, R.O.C.
Insights
Early and adequate treatment of congenital syphilis is crucial for preventing severe outcomes. This study highlights key diagnostic and treatment considerations for congenital syphilis in infants.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Congenital syphilis is a serious, preventable infection transmitted from mother to child.
- Timely diagnosis and treatment are essential to minimize infant morbidity and mortality.
Purpose of the Study:
- To analyze the clinical characteristics, diagnostic methods, and treatment outcomes of congenital syphilis cases.
- To identify factors influencing disease presentation and prognosis in affected infants.
Main Methods:
- Retrospective review of 12 congenital syphilis cases diagnosed between 1983 and 1992.
- Analysis of patient demographics, clinical signs, diagnostic test results (including cerebrospinal fluid and radiological findings), and treatment regimens.
- Comparison of inborn versus outborn patient groups.
Main Results:
- Twelve infants (5 male, 7 female) diagnosed with congenital syphilis, with an average age of 23 days.
- Outborn infants were more likely to be symptomatic and diagnosed at a later age compared to inborn infants.
- Cerebrospinal fluid and bone abnormalities were observed in a significant proportion of patients.
- Penicillin was the primary treatment, with one mortality due to respiratory failure despite adequate treatment.
Conclusions:
- Congenital syphilis requires prompt and effective management to prevent long-term complications.
- Early detection and intervention are critical for improving outcomes in infants with congenital syphilis.
- This study underscores the importance of comprehensive diagnostic evaluation and appropriate therapeutic strategies.
Abstract:
Between 1983 and 1992 at the Taichung Veterans General Hospital, twelve congenital syphilis patients were diagnosed, according to the Centers for Disease Control (CDC) criteria. For the five boys and seven girls, ages at diagnosis ranged from 1 day to 8 months, with an average of 23 days. Among these 12 patients, four (33%) were premature. Seven patients (58%) were diagnosed in the past three years. These 12 patients were divided into inborn and outborn patient groups. Serological tests for syphilis were done in all inborn patients, but none in the outborns. All five outborn patients were symptomatic. In comparison, only one of seven inborn infants showed clinical evidence of congenital syphilis. The mean age at diagnosis was obviously older in the outborn patient group (53 days vs. 1 day). Six of ten patients (60%) had cerebrospinal fluid (CSF) abnormalities, while four of nine (44%) showed radiological abnormalities of bones. The hematologic and biochemical abnormalities compatible with congenital syphilis were also described. Penicillin was the drug of choice in ten patients. Despite adequate treatment, one patient died of respiratory failure. There has been no evidence of any signs of late congenital syphilis in those patients who survive. Congenital syphilis, a serious but preventable disease, is best treated adequately and early for minimal sequelae.