Related Experiment Videos
Congenital syphilis in a newborn: an immunopathologic study
J Guarner1, P W Greer, J Bartlett
1Infectious Disease Pathology Activity, Division of Viral and Rickettsial Diseases, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. jqg8@cdc.gov
Summary
Congenital syphilis, a severe infection in newborns, was confirmed post-mortem using advanced immunohistochemical analysis (IHC). Macrophages formed a characteristic "onion-skin" pattern around blood vessels, revealing the primary immune response.
Area of Science:
- Pathology
- Immunohistochemistry
- Neonatal Infections
Background:
- Congenital syphilis poses a significant risk to newborns, often presenting with diverse symptoms.
- Early diagnosis and treatment are crucial, but mortality remains a concern in severe cases.
Observation:
- A 3-week-old infant with respiratory distress and rash, suspected of congenital syphilis, unfortunately, died.
- Autopsy tissue analysis utilized direct fluorescent antibody and immunohistochemical analysis (IHC) for Treponema pallidum.
Findings:
- The diagnosis of congenital syphilis was confirmed by detecting Treponema pallidum in multiple organs via IHC and direct fluorescent antibody tests.
- Abundant spirochetes were found in the small intestine and liver, with occasional detection in the meninges.
- A consistent finding was a concentric macrophage (CD68-positive) infiltrate around vessels, creating an "onion-skin" appearance, indicating macrophages as the primary immune response.
Implications:
- This study confirms congenital syphilis via detailed histopathological analysis, highlighting the utility of IHC in identifying Treponema pallidum in affected tissues.
- The "onion-skin" pattern of macrophage infiltration represents a key pathological hallmark of congenital syphilis.
- Understanding the macrophage-driven immune response is vital for future diagnostic and therapeutic strategies in neonatal syphilis.