Congenital syphilis

Crissey, John Thorne; Denenholz, David A.

doi:10.1016/0738-081x(84)90018-x

Cited by 9 publications

(11 citation statements)

References 39 publications

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“…This observation is also supported by the inclusion of the criterion in several major reviews of disease clinical diagnosis [4,5,26]. The additional fact that dental stigmata of the disease, such as Hutchinson's incisors and mulberry molars, are only observed in about 30% of all patients [2,11,27], allow us to advocate evaluating the clavicle sign in osteoarcheological studies, especially when cranial data evaluation is missing or remains inconclusive.…”

Section: Resultsmentioning

confidence: 91%

“…The enlargement of the sternal end of the clavicle reaches a permanent stage about the age of puberty and thus becomes a valuable permanent stigma of prenatal syphilis. Histologically, it is a case of sclerotic bone involvement, representing the permanent residue of prior bony inflammation [4,20].…”

Section: First Point Of Evidence: Higoumenakis Signmentioning

confidence: 99%

“…T. pallidum crosses the placental barrier in the maternal circulation to infect the foetus, which subsequently develops a series of signs and symptoms. These clinical manifestations may appear first during gestation, infancy, childhood, or even adult life [4] and are normally divided in early signs which include all aspects of the disease from prenatal infection to the end of the second year of life, and late congenital syphilis thereafter [5]. Congenital syphilis affects almost all the organs.…”

Section: In Anthropological Specimens Introduction: Syphilis and Congmentioning

confidence: 99%

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Higoumenakis’ sign in the diagnosis of congenital syphilis in anthropological specimens

2011

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Higoumenakis' sign (HS) is a diagnostic criterion referring to the enlargement of the sternal end of the (right) clavicle, frequently observed in patients with late congenital syphilis. Although indexed for several years in clinical medicine textbooks, it has not been extensively applied for the diagnosis of congenital syphilis among anthropological specimens. This is highly significant, since the other major palaeopathology findings refer almost exclusively to the skull and diagnosis thus becomes difficult if only peripheral skeletal remains are available for evaluation. The potential effectiveness of the proposed use of HS as a marker of syphilis in anthropology appears adequate, since descriptions very similar to that of HS have been reported for certain findings, although no attempt has been made to correlate them with the presence of the disease. Higoumenakis himself originally observed this sign in 86% of his patients with congenital syphilis, and this report was subsequently verified by other independent researchers. His attempt to explain the pathophysiology of the sign and its localization, on the basis of anatomical, biological, and mechanical reasons, however, has been questioned. On the other hand, the application of the remaining markers of congenital syphilis is also problematic, due to sensitivity and/or specificity limitations, and other signs may not be detected due to inability to retain soft tissue samples in anthropological populations and a lack of reliable techniques for treponematous DNA amplification in such old samples. Thus, the fact that the onset of any of the signs of syphilis is not a constant finding justifies the authors' suggestion that HS should be checked for in any available anthropological specimen, because it is highly indicative of possible infection by Treponema pallidum.

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Section: Resultsmentioning

confidence: 91%

Section: First Point Of Evidence: Higoumenakis Signmentioning

confidence: 99%

Section: In Anthropological Specimens Introduction: Syphilis and Congmentioning

confidence: 99%

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Higoumenakis’ sign in the diagnosis of congenital syphilis in anthropological specimens

2011

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“…Mulberry, or Fournier's, molars occur in CS, but they are not diagnostic because they also develop in other conditions (Hillson et al, ; Iouannou, Sassani, Henneberg, & Henneberg, ; Iouannou, Henneberg, & Henneberg, ). Beyond these dental alterations, macroscopically observable skeletal lesions in both early (onset under 2 years of age) and late (age 3–30 years) stages of CS are indistinguishable from those observed in other forms of treponemal infection (see, for example, Crissey & Denenholz, ; Rasool & Govendor, ), with the possible exception of Higoumenakis' sign of the clavicle (Frangos et al, ). Extensive clinical studies show that the radiologically detectable lesions associated with CS (including Wegner's sign and Wimberger's sign) are age‐related and ephemeral (Brion et al, ; Crissey & Denenholz, :156–157; McLean, ; Rasool & Govender, ).…”

Section: Paleopathologymentioning

confidence: 97%

Advancing the understanding of treponemal disease in the past and present

Baker

Crane-Kramer

Dee

et al. 2020

American J Phys Anthropol

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Syphilis was perceived to be a new disease in Europe in the late 15th century, igniting a debate about its origin that continues today in anthropological, historical, and medical circles. We move beyond this age-old debate using an interdisciplinary approach that tackles broader questions to advance the understanding of treponemal infection (syphilis, yaws, bejel, and pinta). How did the causative organism(s) and humans co-evolve? How did the related diseases caused by Treponema pallidum emerge in different parts of the world and affect people across both time and space? How are T. pallidum subspecies related to the treponeme causing pinta? The current state of scholarship in specific areas is reviewed with recommendations made to stimulate future work. Understanding treponemal biology, genetic relationships, epidemiology, and clinical manifestations is crucial for vaccine development today and for investigating the distribution of infection in both modern and past populations.Paleopathologists must improve diagnostic criteria and use a standard approach for recording skeletal lesions on archaeological human remains. Adequate contextualization of cultural and environmental conditions is necessary, including site dating and justification for any corrections made for marine or freshwater reservoir effects. Biogeochemical analyses may assess aquatic contributions to diet, physiological changes arising from treponemal disease and its treatments (e.g., mercury), or residential mobility of those affected. Shifting the focus from point of origin to investigating who is affected (e.g., by age/sex or socioeconomic status) and disease distribution (e.g., coastal/ inland, rural/urban) will advance our understanding of the treponemal disease and its impact on people through time. K E Y W O R D S archaeological biogeochemistry,

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“…Congenital syphilis occurs when a pregnant woman with primary, secondary, or latent syphilis transmits the infection across the placenta to the fetus during gestation. About 25% of prenatal infections result in stillbirths, while 25 to 30% of newborn infants die shortly after birth and 40% develop late syphilis (5). The risk of in utero infection with Treponema pallidum in untreated early maternal syphilis is estimated to be about 80 to 90% (10).…”

mentioning

confidence: 99%

Experimental model of congenital syphilis

1993

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Female LSH hamsters infected with Treponema pallidum subsp. endemicum before pregnancy or during early pregnancy transmit a form of syphilis to the fetus that is similar to human congenital syphilis. The offspring develops rhinitis, skin rash, failure to thrive, and hepatosplenomegaly. T. pailidum is detectable in their livers, spleens, and nasal secretions. Immunoglobulin M antibodies are detected in the serum.

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Congenital syphilis

Cited by 9 publications

References 39 publications

Higoumenakis’ sign in the diagnosis of congenital syphilis in anthropological specimens

Higoumenakis’ sign in the diagnosis of congenital syphilis in anthropological specimens

Advancing the understanding of treponemal disease in the past and present

Experimental model of congenital syphilis

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