TORCHeS infection
- Maternal infection may present with primary ulcers or secondary rash.
- Neonatal infection
– Stillbirth, Hydrops fetalis.
– Can be asymptomatic.
Early congenital syphilis (first 2 years)
- Rash on palms/soles of feet
- Lymphadenopathy
- Hepatosplenomegaly
- Snuffles (nasal discharge, rhinitis)
- Pseudoparalysis due to skeletal abnormalities (osteochondritis, metaphysitis, periostitis of long bones).
- Long bone abnormalities:
– Wimberger’s sign (bilateral destruction of the proximal tibial metaphysis)
– Sawtooth (serration) metaphyses (aka, Wegener sign)
– Periostitis of diaphysis
– Darkfield microscopy, CSF analysis
Late congenital syphilis
–
Hutchison teeth, interstitial keratinitis, sensorineural hearing loss
– Gummatous ulcers (nose, septum, hard palate)
– Perforation of hard palate
– Rhagades (perioral fissures, cracks, or scars)
– Frontal bossing (abnormally prominent forehead)
– Mulberry molars
– Saber shins (anterior bowing of tibia)
– Cranial nerve palsies
– Intellectual disabilities
– Serology
– Penicillin
References & Image Credits
“Congenital Syphilis.” Wikipedia, April 29, 2018. https://en.wikipedia.org/w/index.php?title=Congenital_syphilis&oldid=838862112.
“Congenital Syphilis - Pediatrics.” Merck Manuals Professional Edition. Accessed September 11, 2018. https://www.merckmanuals.com/professional/pediatrics/infections-in-neonates/congenital-syphilis.
“Details - Public Health Image Library(PHIL).” Accessed September 11, 2018. https://phil.cdc.gov/Details.aspx?pid=3823.
NIH. Frontal Bossing. Accessed September 11, 2018. https://elementsofmorphology.nih.gov/index.cgi?tid=a223995bdef3e8d6.