An analysis of the clinical features of children with early congenital Syphilis and Syphilitic Hepatitis

Abstract

Background The infection rate of congenital syphilis is gradually increasing, the clinical manifestations of some children with congenital syphilis are abnormal liver function, which is given the clinical diagnosis of syphilitic hepatitis. At present, there are few studies on the clinical features of children with early congenital syphilis combined with syphilitic hepatitis, so we set out to do such a study. We compared the liver function indicators before and after the treatment of syphilis to find the clinical features that can provide guidance for clinical diagnosis and treatment. Methods This study collected clinical data on 51 children with early congenital syphilis combined with syphilitic hepatitis in Beijing Ditan Hospital, affiliated with Capital Medical University, between April 2014 and October 2019. We observed their age, gender, clinical symptoms, and physical symptoms, as well as the pregnancy and childbirth history of their mothers. We also compared the liver function indicators before and after the treatment of the syphilis and analyzed the children’s clinical features. Results The results of this study showed that the clinical manifestations in children with early congenital syphilis combined with syphilitic hepatitis were diverse. The most common clinical manifestation was anemia (56.9 %), followed by syphilitic rash (54.9 %), hands, feet, and whole-body peeling (35.3 %), and splenomegaly (29.4 %). Liver damage caused by a syphilis infection tends to result in elevated alanine aminotransferase, aspartate aminotransferase, and bilirubin, while albumin decreases. After the syphilis treatment, the liver function indexes were significantly improved compared with before treatment, and the difference was statistically significant (all p < 0.05). Conclusions A child with abnormal liver function, especially with anemia, skin rash, peeling, abdominal distension, and hepatosplenomegaly should be highly suspected of having a syphilis infection. Once the diagnosis is made, the appropriate standard penicillin treatment should be started as soon as possible to improve the condition and prognosis of the child.

Newborn with skin rash, hepatosplenomegaly and red buttocks

“…The infant's syphilis RPR titre was eight times higher than that of the mother, which is not uncommon and is due to selective transfer of IgG antibodies across the placenta. Liver involvement with raised liver enzymes is common in congenital syphilis 1,2 . A lumbar puncture was normal, excluding congenital neurosyphilis.…”

Gambaran karekteristik kejadian sifilis kongenital di RSUD Wangaya, Kota Denpasar

“…anemia ini lebih banyak ditemui pada kasus infeksi sifilis yang disertai dengan hepatitis, hingga 56,9% kejadiannya. 16 Lesi kulit ditemui pada 12,8% subjek sifilis simptomatik pada penelitian ini. Lesi kulit yang paling sering ditemui pada sifilis kongenital adalah deskuamasi maupun multipel bula pada daerah palmoplantar, yang merupakan salah satu gambaran khas dari sifilis kongenital yang dikenal dengan phempigus syphiliticus.…”