Effect of Penicillin in the Treatment of Infantile Congenital Syphilis

Platou, R. V.; Hill, Allan J.; Ingraham, Norman R.; Goodwin, Mary; Wilkinson, Erle E.; Hansen, Arild E.

doi:10.1001/archpedi.1946.02020350002001

Cited by 13 publications

(4 citation statements)

References 2 publications

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“…There are no accurate data on the prevalence of CS nephropathy due to the lack of systematic studies. An earlier study summarized 122 cases of early CS and found no definite cases of syphilitic nephropathy [ 26 ]. A recent study in Argentina reviewed 61 cases of CS, including 4 of syphilitic nephropathy, with a prevalence of 6.6% 2 .…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of infants hospitalized with early congenital syphilitic nephropathy: a single-center retrospective cross-sectional study in China

Wang,

Lun,

Pang

2023

BMC Pediatr

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Background Early studies claimed that early congenital syphilitic (CS) nephropathy was rare, and systematic studies about this disease are absent, which may lead to poor awareness of early CS nephropathy in clinicians and result in misdiagnosis and poor patient prognosis. The present study systematically and comprehensively analyzes the clinical characteristics of infants with early CS nephropathy hospitalized in Beijing Ditan Hospital, an infectious disease hospital in China in order to improve the understanding and management of this disorder. Methods Data of the children with early CS from July 1, 2008, to December 31, 2021, were collected from the electronic medical record system of the hospital. Each patient’s demographic characteristics, clinical history, mother’s history of syphilitic infection, and laboratory values were extracted. The patients were enrolled to either the nephropathy group or the non-nephropathy group depending on diagnosis. Descriptive statistics was used to report basic demographics, clinical and laboratory test values, and variables were compared between the two groups by nonparametric tests, t test or χ2 tests. Results Of the 122 children with early CS enrolled, 24(19.7%) were diagnosed with early CS nephropathy. All of the children with CS nephropathy were young infants < 6 months old. A majority of them showed typical congenital syphilitic skin lesions, but a quarter of them did not have skin lesions. Compared with non-nephropathic children with early CS, those with nephropathy had higher frequency of hepatosplenomegaly, fever, edema, gastrointestinal (GI) symptoms, and anemia, as well as decreased C3 levels. Urinalysis results showed hematuria in all patients with early CS nephropathy, with proteinuria and renal function impairment in 91.7% and 12.5% of the patients, respectively. Nephritic-type nephrotic syndrome and glomerulonephritis were diagnosed in 45.8% and 54.2% of these patients, respectively. All infants with CS nephropathy were cured or improved after appropriate treatments. Conclusion Infants with early CS nephropathy often presented with nephritic-type nephrotic syndrome or glomerulonephritis, and the typical skin lesions, fever, hepatosplenomegaly, and edema, etc., were its common clinical presentations, and these characteristics could help with the diagnosis. But for infants with nephropathy who did not have typical clinical presentations, CS should also be screened as an important etiology to avoid misdiagnosis.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of infants hospitalized with early congenital syphilitic nephropathy: a single-center retrospective cross-sectional study in China

Wang,

Lun,

Pang

2023

BMC Pediatr

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“…Significant renal involvement is infrequent in cases of CS and may vary from simple albuminuria to nephritis or NS. The incidence rate of CNS in CS range from 0.5% (10) to 2.4% (11). It has been considered to result from direct invasion of the kidney by spirochetes or secondary to a hypersensitivity reaction.…”

Section: Discussionmentioning

confidence: 99%

Congenital Syphilis Presenting with Only Nephrotic Syndrome: Reemergence of a Forgotten Disease

et al. 2017

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Syphilis infection has re-emerged after years of declining incidence. The prevalence of congenital syphilis (CS) has increased in Korea and other countries during the last few decades. Untreated infants develop symptoms such as rhinorrhea, anemia, jaundice, cutaneous lesions, hepatosplenomegaly, and pseudoparalysis within weeks or months. Significant renal disease is uncommon in CS, and clinical renal involvement varies from mild transient proteinuria to frank nephrosis. We report a 2-month-old infant with CS who presented with only nephrotic syndrome (NS). The previously healthy infant presented with NS and showed no other syphilitic manifestations. Remission of the NS was achieved with adequate penicillin treatment. No recurrence of proteinuria was observed during the 1 year of follow-up. Although rare, this long forgotten disease continues to affect pregnant women, resulting in prenatal or postnatal mortality. We still consider the possibility of syphilitic nephropathy and therefore serologic testing for congenital NS.

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“…The extent of clinical renal IGn-Rolvement aine sylismaywvar fromhtsrime albuminuria to more significant disease such as the nephrotic syndrome or nephritis. Platou et al (1946) found clinical renal involvement in only one of 191 cases. Our patient fulfils the criteria for congenital syphilitic renal disease with evidence of syphilis in the mother, unequivocal evidence of congenital syphilis in the patient, and absence of other aetiology for his nephrotic syndrome (Scully and Yamnazaki, 1949).…”

Section: Discussionmentioning

confidence: 99%