Congenital Syphilis

Congenital syphilis

Congenital syphilis is a severe and often fatal infection among fetus and infants that is caused by a spiral shaped bacterium called Treponema pallidum. The bacterium is passed on by the mother to the baby commonly through the transplacental route. Around 50% of the infected babies die while inside the womb or shortly after being born. Congenital syphilis may be categorized as early or late. The early type manifests from birth up to two years of age with most cases identified during the first three months of life. Beyond two years of age, the disease is considered as late type. It is extremely important to detect the disease early so that screening during prenatal visits is very much promoted especially to mothers at high risk. ^[1]

Causes

The causative organism is a gram negative, motile type of bacterium named Treponema pallidum.  In congenital syphilis, this bacterium readily crosses the placenta. Adults usually acquire the disease via sexual activities that involve direct contact with a syphilis sore that can be located in the genitals, anal or the mouth area. ^[2][3][4]

Signs and Symptoms                                                                                 

Many patients do not have symptoms. In early congenital syphilis, the patient may have skin rashes or blisters in the palms or soles. Some may have pinpoint rashes at the diaper area. Others present with a watery or bloody nasal discharge. Newborns may find it difficult to thrive and may develop pneumonia, meningitis and hydrocephalus. Some patients may have intellectual impairment and pseudoparalysis.

Late onset type symptoms include bone pain, blindness, deafness, joint swelling and skin lesions in the mouth, genitals and anus. The patient may also have an abnormally notched set of teeth referred to as Hutchinson teeth. ^{[1] [2] [4]}

Diagnosis

Screening tests conducted during pregnancy such as Fluorescent Treponemal Antibody Absorption (FTA-ABS) test, Rapid Plasma Reagin (RPR) test and Venereal Disease Research Laboratory (VDRL) test may detect congenital syphilis. When the disease is suspected at the time of birth, the placenta is often assessed. Pediatric patients usually undergo laboratory exams including eye tests, dark-field exams, lumbar puncture and bone imaging tests. ^[2]

Treatment

Penicillin is the standard drug used in treatment. When treatment is started early, serious consequences are frequently avoided. ^[4]

References:

1.      http://www.merckmanuals.com/professional/pediatrics/infections_in_neonates/congenital_syphilis.html

2.      http://www.nlm.nih.gov/medlineplus/ency/article/001344.htm

3.      http://virology-online.com/Bacteria/Spirochaetes.htm

http://www.childrenshospital.org/az/Site3229/mainpageS3229P1.html

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