Contribution of Long-Bone Radiographs to the Management of Congenital Syphilis in the Newborn Infant

Moyer, Virginia A.; Schneider, Virginia; Yetman, Robert J.; Garcia‐Prats, Joseph A.; Parks, Deborah; Cooper, Timothy R

doi:10.1001/archpedi.152.4.353

Cited by 27 publications

(8 citation statements)

References 11 publications

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“…[13,25,29] X-ray examination of bones was only performed in the patient with clinical signs of bone involvement. [30] Although lumbar puncture in congenital syphilis is recommended in all cases in current guidelines, [13,18,25,[31][32][33] it was not performed in our series due to lack of resources (material and fi nancial), and due to no realistic chance for additional meaningful information in view of the meagre laboratory facilities available. [16] Therefore all patients were treated for 10 days as if CSF infection would have been present although no infant had clinical signs of meningitis.…”

Section: Discussionmentioning

confidence: 99%

Congenital syphilis: still a serious, under-diagnosed threat for children in resource-poor countries

Krüger

Malleyeck

2010

World J Pediatr

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Highlighting the variable picture of congenital syphilis, this report demonstrates how difficult it is to make a correct diagnosis by solely history and clinical presentation in a resource-poor setting. Hence false-positive and false-negative diagnoses are common, and clinicians have to maintain a high index of suspicion in diagnosing congenital syphilis. Therefore, an important approach to control and finally eliminate congenital syphilis as a major public health problem will be universal on-site syphilis screening of all pregnant women at their first antenatal visit and immediate treatment for those who test positive.

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Section: Discussionmentioning

confidence: 99%

Congenital syphilis: still a serious, under-diagnosed threat for children in resource-poor countries

Krüger

Malleyeck

2010

World J Pediatr

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“…Apesar de as fraturas ocorrerem preferencialmente nas metáfises, elas também podem acometer as diáfises ósseas (2,3,5,7) . assintomáticas, apresenta positividade menor de achados, geralmente não-típicos, variando de 0,8% a 20% dos casos (10)(11)(12) . A razão dessa diferença na freqüência de achados relaciona-se com a precocidade com que a investigação é realizada (menos de uma semana de vida) e no alto grau de suspeição da doença, nos dias de hoje (9) .…”

Section: Discussionunclassified

Sífilis congênita simulando a síndrome da criança espancada: relato de caso

2002

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As autoras descrevem os achados radiológicos dos ossos longos de um recém-nascido com diagnóstico confirmado de sífilis congênita, enfatizando o diagnóstico diferencial com a síndrome da criança espancada. É apresentada a evolução radiológica das lesões nos ossos longos, do nascimento até o quarto mês de vida. Os dados clínicos e laboratoriais do recém-nascido, as radiografias anteriores e os achados radiológicos característicos da doença de base foram essenciais para o diagnóstico desta doença. Unitermos: Sífilis congênita. Síndrome da criança espancada. Fraturas ósseas. Congenital syphilis mimicking battered child syndrome -case report.We report the radiographic findings in the long bones of a newborn with confirmed diagnosis of congenital syphilis and discuss the differential diagnosis with battered child syndrome. The radiographic findings in the long bones from birth to the fourth month of life are presented. Clinical and laboratory data, the serial x-ray films and the characteristic radiological signs were essential to establish the correct diagnosis. Recebido para publicação em 23/11/2001. Aceito, após revisão, em 2/4/2002.

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“…There is accumulation of calcified matrix at the epiphyseal margin that may be serrated. There is a mouse‐eaten appearance 2 . Other symptoms include rhinitis, snuffles, hepatosplenomegaly, etc.…”

Section: Discussionmentioning

confidence: 99%

Early congenital syphilis

Rengui

et al. 2001

Int J Dermatology

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Case 1 A boy was delivered at 35 weeks' gestation by standard vaginal delivery. His mother was a 24‐year‐old gravida 4, para 1 woman. Purple erythematous macules and diffuse vesicular eruptions of various sizes were found extensively over the skin. The rapid plasma reagin (RPR) titer test of the newborn showed 1 : 16 positive and 1 : 32 weakly positive. There was no obvious history of maternal or paternal syphilitic infection; however, the mother confessed to having sexual contact with other men, and had a history of extrauterine pregnancy and spontaneous abortion. She showed a 1 : 8 positive and 1 : 16 weakly positive RPR titer test. The father's RPR titer was 1 : 8 positive and Treponema pallidum hemagglutination (TPHA) test was 1 : 160 positive. Physical examination revealed that this 2300‐g boy had a rapid respiration of 55/min. The Apgar score was eight at 1 min. The boy's temperature was 36 °C. He had a normal skull, and the size of the bregma was 1.2 cm × 1.2 cm. The intranasal septum was normal with excessive excretions in the nostrils. The lips were slightly red. His intraoral mucous membrane was smooth, and his pharynx and throat were normal. His respiratory movement was symmetrical. He had sinus rhythm (135 b.p.m.) and no signs of abnormality. His breathing sound was clear with signs of effusion. The abdominal examination revealed hepatosplenomegaly. There was no transudate from the umbilicus. The liver was palpable 2 cm below the costal margin. The spleen was also palpable just below the costal margin. The movement of the boy's limbs was normal. The fingernails had developed to the end of the fingers. The pleat drape of the metatarsal was less than one‐third of the foot area. The boy had normal neural reflexes including rooting, sucking, and Moro reflex. Examination of the skin revealed a light purple color all over the body, with diffuse reddish‐copper maculopapules, over which there were pale vesicles about 0.5‐1.2 cm in size. Part of the vesicular eruption that occurred especially on the palms and soles had ruptured (Figs 1‐6). The majority of the body surface was involved, but mucosal involvement was not noted. 1 Reddish‐copper maculopapules with pale vesicles especially on the extremities 2 Eruption on the face with ruptured vesicles 3 Vesicles on the soles and ruptured vesicle on the toe 4 Maculopapules and vesicles on the instep 5 Vesicles on the back of the hand with denuded area 6 Erythematous macules around vesicle on the buttock Laboratory examination revealed the following values: leukocyte count, 25.9 × 109 /L, containing 72% neutrophils and 23% lymphocytes; red blood cell count, 4.62 × 1012 /L; hemoglobin, 173 g/L; and platelets, 117 × 109 /L. The urine test, excretion test, and blood chemistries were normal. The culture of the vesicular fluid was negative with no bacterial growth. Roentgenography was normal. The RPR titer test showed 1 : 16 positive and 1 : 32 weakly positive. Two weeks later, re‐examination of blood routine tests showed: white blood cell count, 13.3 ...

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Contribution of Long-Bone Radiographs to the Management of Congenital Syphilis in the Newborn Infant

Cited by 27 publications

References 11 publications

Congenital syphilis: still a serious, under-diagnosed threat for children in resource-poor countries

Congenital syphilis: still a serious, under-diagnosed threat for children in resource-poor countries

Sífilis congênita simulando a síndrome da criança espancada: relato de caso

Early congenital syphilis

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