Late congenital syphilis
Late congenital syphilis is registered in children older than 2 years. Most often, the disease is detected in children 14 - 15 years and older, the disease in which proceeds according to the type of tertiary syphilis. In children 2-5 years the disease has the same clinical manifestations as in early congenital syphilis. In some children, syphilis has a hidden course.
It is believed that late congenital syphilis is a recurrence of a previously untreated or undertreated disease. Most often this happens when early congenital syphilis proceeded covertly, either asymptomatically or the symptoms of the disease were completely absent.
A characteristic feature of late congenital syphilis is the presence of specific symptoms:
- reliable, indicating the presence of the disease,
- probable, requiring confirmation of the diagnosis,
- a group of signs (dystrophy, stigma), also found in other infectious diseases and intoxications. They do not have any diagnostic value and only indicate the likely defeat of the patient with syphilis and help with the diagnosis.
To reliable signs of late congenital syphilis include: degeneration of teeth, labyrinth deafness and parenchymal keratitis. Sometimes this group of diseases includes specific permits and then the triad is called the tetrad.
To the likely signs of late congenital syphilis include: saber drumsticks, radar scars around the mouth opening (Robinson – Fournier scars), tooth deformities, buttock-like skull, syphilitic chorioretinitis, syphilitic chases, damage to the nervous system.
To dystrophy (stigma) include: high (Gothic) sky, thickening of the sternal end of the clavicle, shortening of the little fingers of the hands, absence of the xiphoid process, etc.
Most often, in late congenital syphilis, several signs are recorded. One of the signs is recorded in 29% of cases.
Fig. 1. Getchinson teeth - a reliable sign of late congenital syphilis.
Reliable signs of late congenital syphilis
Jonathan Getchinson, an English dermatologist, surgeon, syphilidologist and ophthalmologist in 1852 described the symptoms of late congenital syphilis - labyrinth deafness, parenchymal keratitis and tooth damage. At the suggestion of the French dermatologist and venereologist A. Fournier, these symptoms were called the Getchinson triad. In the name of this scientist are also called some of the symptoms of spinal tabes.
Fig. 2. Pictured is Jonathan Getchinson.
Anomalies of dental development in congenital syphilis
The triad of congenital syphilis includes developmental abnormalities (hypoplasia) of teeth. In children with congenital syphilis, pathology such as Getchinson, Fournier and Pfluger teeth is recorded. The cause of the development of these hypoplasias is the effect of syphilitic infection on the metabolic processes in the buds of the teeth, as a result of which a malformation of the organ is formed.
- D. Getchinson for the first time described a special form of pathology of the central incisors, in which the semi-lunar cutting of the cutting edge was determined. However, this sign of congenital syphilis was recognized even by D. Getchinson only if there are 2 more signs - deafness and parenchymal keratitis.
- A. Fournier pointed out that congenital syphilis is characterized not by a semilunar notch, but by a barrel-shaped crown, when the tooth neck is larger than that of the cutting edge in the absence of a semilunar notch.
- Another anomaly of dental development in congenital syphilis is Pfluger's teeth. Pathology is characterized by the defeat of exclusively the first large molars (molars) - the wide neck of the tooth (wider than that of the chewing surface) and a significant degree of underdevelopment of the hillocks. In this case, the tooth becomes kidney-shaped.
- Pfluger's teeth, an additional tubercle from the side of the tongue in the first molars (Karabelli's tubercle), thinning of the free edge of the canine (Fournier's bristle tooth), pouch-like fangs, widely placed teeth of the upper row, dwarf teeth and the growth of teeth on the hard palate are likely signs of congenital syphilis.
The formation of the pathology of permanent teeth occurs when they are laid - at 6–7 months of pregnancy, when placental blood circulation is already functioning and pale treponems penetrate the fetus, exerting its negative effect. The laying of milk teeth occurs in the fetus even before the transition to placental circulation, so this pathology is not observed in them.
Fig. 3. In the photo a) Fournier's teeth, b) Pfluger's teeth.
Fig. 4. Abnormal development of teeth in congenital syphilis.
Teeth of getchinson
The triad of symptoms of congenital syphilis in children includes such a symptom as Getchinson's teeth. This pathology occurs in 5 - 20% of cases. Getchinson's teeth are a special form of hypoplasia, in which changes in the upper incisors are recorded:
- the neck of the teeth is wider than the area of the cutting edge within 2 mm, therefore the teeth crowns take the form of a screwdriver or barrel-shaped,
- on the bottom edge of the incisors there are semilunar notches,
- the semilunar notch is sometimes covered with enamel, sometimes the enamel is present only at the corners of the tooth, sometimes the enamel is completely absent, often the enamel covers the entire notch, but is quickly worn down,
- as soon as the teeth are cut, on the cutting edge in the middle you can see 3 - 4 spines that quickly break off,
- gradually, the incisors grind off and by the age of 20 the teeth become short and wide, often with carious edges.
Treatment of dental pathology consists in restoring the size and anatomical shape of an organ using artificial crowns or composite materials after the final formation of a permanent bite.
Fig. 5. Pictured Getchinson's teeth. On the edge of the lower lip, Robinson-Fournier scars are clearly visible.
Syphilitic parenchymal keratitis
Parenchymal keratitis among the Getchinson triad is most common and accounts for 48% of cases. When the disease affects the middle layer of the cornea (middle stroma). Tearing, photophobia, pain, blepharospasm and corneal clouding are the main signs of syphilitic parenchymal keratitis. The disease leads to a decrease or complete loss of vision. Bilateral lesion occurs in half of the patients. Often, parenchymal keratitis is the only sign of late congenital syphilis.
Initially, specific inflammation develops in one eye. The second eye is affected after weeks, more often - after 6 - 10 months, but maybe after years.
Parenchymal keratitis can manifest itself in the form of limbal, central, annular and avascular forms.
- The disease begins with corneal opacities, which are focal or diffuse. In the diffuse form, the entire cornea is clouded by turbidity, it has a milky color and greater intensity in the center. In the case of the focal variant, the turbidity has the form of cloud-like spots.
- After 4-6 weeks, a ciliary or ciliated injection (dilation of the vessels) appears around the edge of the cornea (limbus), which has a purple color. Newly formed vessels grow into the cornea, sometimes there are so many of them that the cornea takes on the appearance of ripe cherries. The vessels of the outer outer membrane of the eye, the conjunctiva, expand. The process takes 6 to 8 weeks. Often, along with parenchymal keratitis, patients develop inflammation of the iris and choroid, ciliary body (iritis, chorioretinitis, iridocyclitis) and optic nerve atrophy.
- The period of reverse development is slow. The cornea on the periphery is clarified, the turbidity in the center of the eye resolves. Restored vision. Photophobia and pain are reduced. Recovery lasts more than a year.
The inflammatory process takes a long time and often ends with corneal clouding, which manifests itself in the form of impaired visual acuity or complete blindness. A significant degree of vision loss is noted in 3 - 4 parts of patients. Not earlier than one year after the disease, relapses of parenchymal keratitis may occur, often occurring as an avascular form. Empty vessels are always detected by ophthalmoscopy, therefore, the diagnosis of previously transferred syphilitic chorioretinitis can be made retrospectively. All patients revealed positive specific serological reactions.
Fig. 6. Parenchymal keratitis in late congenital syphilis.
Syphilitic labyrinthitis (labyrinth deafness)
Labyrinth deafness is rarely registered - in 3–6% of cases, between the ages of 5 and 15 years, mainly in girls. When the disease in the maze (often from 2 sides) develops hemorrhagic inflammation, which is often accompanied by noise and ringing in the ears. Sometimes the disease is asymptomatic and ends with sudden deafness.
If maze damage develops in children under the age of four, the child may become deaf and dumb. Syphilitic labyrinthitis is difficult to treat.
Fig. 7. Inflammation of the labyrinth, periostitis and damage to the auditory nerve in syphilis lead to deafness.
Detection of at least one reliable trait from Getchinson's triad and the receipt of positive serological reactions indicates the presence of late congenital syphilis in the child.
Probable signs of the disease
Probable signs of the disease require the doctor to further confirm the diagnosis, as they can occur in other diseases. When diagnosing, it is necessary to take into account other specific manifestations of syphilis, anamnesis data and the results of a family survey of the child. Chorioretinitis, nasal deformities and the buttock-like skull, dental degenerations, radial scars on the chin and around the lips, saber tibiae and races are the main likely signs of congenital syphilis.
This pathology is formed in infancy and accounts for about 60% of all lesions in late congenital syphilis. When the disease affects the periosteum and bone tissue of the tibial bones (osteoperiosteitis), as well as cartilage with the presenting bone (osteochondritis), which under the weight of the child gradually bend. The bend forms at the front and resembles a saber blade. The bones themselves are lengthened and thickened. The child is disturbed by night pains. The bones of the forearm are somewhat less common. The diagnosis is confirmed radiologically. A similar picture is observed with Paget's disease. When rickets bones are bent outwards.
Fig. 8. Radiograph of saber tibia (left) and crest-like periostitis (right).
Fig. 9. In the photo saber tibia in a child.
Syphilitic drives are first described in 1886 by Cletton. Of all the lesions with congenital syphilis drives is 9.5%. When the disease affects the synovial membrane and the bag of the knee, rarely elbow and ankle joints. Cartilage and bone epiphyses are not affected. The process is more often bilateral, but at first one joint becomes ill. Syphilitic persecution proceeds without fever, sharp pains and dysfunctions. The joints are increasing in volume, the skin above them does not change color. Liquid accumulates in the cavities. Chronic. There is resistance to specific therapy. Wasserman reaction always gives a positive result.
Fig. 10. Syphilitic persecution is a likely sign of late congenital syphilis. In the photo on the left, protrusions of the synovial membranes of the articular bags of the knee joints are visible.
Nasal deformity in congenital syphilis is recorded in 15–20% of cases and is the result of syphilitic rhinitis at an early age. Saddle nose becomes as a result of the destruction of the bones of the nose and nasal septum. The nose falls, and the nostrils come forward. Small-cell diffuse infiltration and atrophy of the nasal mucosa and cartilage lead to the formation of a goat or lornetoid nose.
Fig. 11. The consequences of late congenital syphilis - saddle nose.
The gluteal skull is formed in the first months of a child’s life. Periostitis and osteoperiosteum of the flat bones of the skull leads to a change in its configuration - the frontal tubercles stand forward, between them is a groove (buttock-like skull). With hydrocephalus, all skull sizes increase.
Fig. 12. The photo on the left shows enlarged frontal bumps, on the right is a view of the cranium for hydrocephalus.
Robinson Fournier Scars
Robinson-Fournier scars are recorded in 19% of children with late congenital syphilis. They are caused by Gohsinger’s diffuse papular infiltration during infancy. Radial scars are located on the chin, forehead, around the lips and the corners of the mouth. Scars remain on the skin of the child after suffering pyoderma, candidiasis and burns.
Fig. 13. In the photo, diffuse infiltration of the skin of Gokhsinger with early congenital syphilis.
Dystrophic lesions of the teeth
Pfluger's teeth (read above), an additional tubercle on the side of the tongue in the first molars (Karabelli tubercle), thinning of the free edge of the canine (Fournier's squint tooth), clean-like fangs, widely placed teeth of the upper row, dwarf teeth and the growth of teeth on the hard palate are likely signs congenital syphilis.
Fig. 14. Karabelli's tubercle is an accessory tubercle located on the chewing surface of the first molar of the upper jaw (No. 5 in the figure). Anomaly is often bilateral in nature.
Fig. 15. In the photo, widely set teeth and Fournier's pike teeth for late congenital syphilis.
The occurrence of a number of dystrophies in congenital syphilis is not associated with the effects of pale treponema (pathogens of syphilis) and do not have any diagnostic value. They develop with many infectious diseases and intoxications, for example, with parents' alcoholism. Stigma may indicate a child’s syphilis is likely to be affected and may help in making a diagnosis.
Fig. 16. Enlarged and protruding frontal and parietal mounds without a separation groove ("Olympic forehead"). Anomaly occurs in 36% of patients.
Fig. 17. High hard palate (“pointed” or “gothic”) occurs in 7% of cases.
Fig. 18. Diastema (distance, gap) between the central incisors. More common in the upper jaw.
Fig. 19. A thickened sternal end (usually right) of the clavicle (a symptom of Ausitidian-Igumenakis) occurs in patients with congenital syphilis in 25% of cases. The cause of the pathology is hyperostosis. In 13–20% of cases with congenital syphilis, there is an absence of the xiphoid process (Keir's axiopathy).
Fig. 20. The shortened (infantile) little finger (Dubois symptom) is recorded in 12% of cases with congenital syphilis. The little finger can be twisted and turned in the direction of the rest of the fingers (Gissar symptom).
Fig. 21. Stigmas that indicate congenital syphilis can be spider-like fingers — anomalously long and narrow fingers (arachnodactylia).
Fig. 22. Girls and boys with congenital syphilis may experience hypertrichosis - hair growth on the forehead (Tarkovsky hypertrichosis).
Damages of internal organs
The pathology of internal organs in congenital syphilis is recorded in 20–25% of cases. The liver, spleen and kidneys are most often affected. In syphilitic lesions of the heart, all its membranes, valves and vessels are affected. There is dysfunction of the thyroid, pancreas, thymus and sex glands, pituitary and adrenal glands.
Nervous system lesions
Pathology of the nervous system in congenital syphilis occurs in 27 - 43% of cases. Of these, more than 50% is caused by brain damage, 32% by the spinal cord, 11% by spinal marrow. In 23% of cases, mental inferiority develops. In case of congenital syphilis, mental retardation, speech disorder, hemiplegia and hemiparesis, dorsal wort, and Jackson epilepsy are recorded. The child is constantly worried about headaches. A secondary atrophy of the optic nerves develops.
Syphilitic chorioretinitis leads to changes in the retina and choroid. Visual acuity is not reduced. Atrophy of the optic nerve leads to loss of vision. When syphilis occurs in children, a combination of chorioretinitis and damage to the optic nerve is more common.
Fig. 23. In the photo, chorioretinitis in early congenital syphilis. The disease is characterized by the symptom of "salt and pepper", which is characterized by the appearance on the periphery of the fundus of the pigment pigment and depigmentation zones.
Late congenital syphilis develops hillock-ulcers and gummous syphilides. Hillocks are rare. More often appear gummous syphilides. Hillocks and gummas with congenital syphilis are prone to rapid ulceration and decay. Gum (infectious granulomas) destroy tissue at their sites. The destruction of the bones and cartilage of the nose leads to its deformation, the destruction of the hard palate leads to its perforation.
Symptoms of late congenital syphilis occur after two years of age, by five or six years, but most often the final clinical picture is formed during puberty. Клиническая картина патологии может характеризоваться как набор специфических признаков, свойственный третичному сифилису.
In the tissues, on the skin, mucous membranes there are a large number of syphilides (nodes resembling tumors), inflammatory and purulent-necrotic processes develop in solid (bone and cartilage) and surrounding soft tissues.
Late congenital syphilis occurs in the absence of adequate therapy for early congenital syphilis. In the overwhelming number of children, congenital syphilis disappears without symptoms or is expressed in the presence of a positive reaction in a blood test.
In some cases, early congenital syphilis does not appear at all, even serologically.
Symptoms of acquired tertiary syphilis correspond to the manifestations of congenital syphilis. The patient has pathological disorders of the nervous system, rheumatoid manifestations, inflammatory processes in various organs: cardiac muscle, liver, lungs, gastrointestinal tract, as well as in the solid tissues of the body.
Late congenital syphilis is characterized by the presence of several groups of symptoms. The first group consists of symptoms that clearly indicate a pathology, the second group includes signs that are more likely to indicate a disease, but require confirmation.
There is also a group of symptoms that can be described as dystrophic changes, also observed in patients, but not directly pointing to late congenital syphilis.
The Getchinson Triad
Reliable symptoms are the so-called Getchinson's triad, as well as the curvature of the bones of the leg relative to the sagittal plane, called the "saber shin." Hetchinson's triad includes such signs as parenchymal keratitis, labyrinth deafness and degeneration of teeth. All three pathologies are simultaneously observed extremely rarely.
One of the symptoms pointing to congenital syphilis is the underdevelopment of dental tissue caused by impaired fetal formation. This is a symptom characterized by dystrophy of dental tissue and enamel. The shape of the lower edge of the central incisors with such a lesion resembles a crescent or sickle, and the shape of the tooth itself is distinguished by expansion around the gum, the tooth resembles a barrel or a screwdriver.
With such a lesion, there is a lack of enamel on the chewing edge. Such teeth are grinded early, at about the age of twenty they become wide and short, with noticeable caries.
In almost half of the cases of late congenital syphilis, parenchymal keratitis occurs, which is part of Getchinson's triad. This is the most common symptom indicating a pathology. It appears as corneal clouding, uncontrolled tearing, photophobia. In most cases, pathology is first observed on one eye.
Involvement in the pathological process of the second eye occurs after some time. The patient gradually loses visual function, a decrease in visual acuity is observed in all. Opacification of the cornea of the eye can be both diffuse and focal. Inflammatory processes of the iris, the posterior part of the eyeball, dilation of the vascular network, and retinal lesions may also develop.
The third symptom from Getchinson's triad is quite rare. Labyrinth deafness is mainly observed among female patients, aged from five to fifteen years. Under the influence of inflammatory processes and hemorrhages against the background of dystrophic changes of the auditory nerves deafness develops. With the development of pathology in the age of up to three years, there are also speech disorders up to complete muteness. This symptom is resistant to therapy.
What is Late congenital syphilis -
Congenital called syphilis, which is transmitted to the unborn child by transplacental blood through the mother’s blood.
Late congenital syphilis usually detected after 15-16 years, and until then does not manifest itself. However, sometimes the symptoms of late congenital syphilis appear from the third year of life.
These symptoms of congenital syphilis are not specific and require additional measures to confirm the diagnosis.
Often, patients have inflammation of the knee joint, characterized by edema, low mobility in the absence of pain. This symptom is usually symmetrical. Ankles and elbow joints may also be affected.
Various pathologies of nasal cartilage are observed in 20% of cases. The nose takes on various forms due to the deformation of the bones, their destruction under the influence of inflammatory processes. Observed deformities of the bones of the skull on the background of inflammation of the bones. The frontal bones are most often deformed, forming two protrusions in the front upper part of the head.
In 20% of cases in patients with congenital abnormalities, colloidal scars form in the chin, neck, and around the lips. Pathology develops as a result of purulent processes at the age of up to a year.
In most cases of congenital syphilis, organic lesions of the central nervous system are diagnosed, characterized by mental retardation, speech disorders, insufficient contractility of the muscles up to complete paralysis, usually on the one hand.
Pathology is diagnosed on the basis of information about a syphilitic infection in the history of the mother, active or cured, the identification of specific pathologies indicating congenital syphilis, the presence of the Getchinson triad, as well as positive serological reactions.
X-ray examinations of bones and joints are used to establish the diagnosis, and CSF biopsy can also be performed.
The main method of treatment of syphilis is the use of penicillin derivatives, prescribed in significant dosages and carried out by long courses. Treponema is the only microorganism today that is sensitive to penicillin.
If you are hypersensitive or if the resistance of a strain is detected, other antibiotics may be used for treatment. Erythromycin and tetracycline derivatives are effective antibiotics for treating syphilis.
With the defeat of the central nervous system, the methods of complex administration of antibiotics are used, together with the intake of tablets and injections, the drugs are also introduced into the subarachnoid space. This is achieved by successfully overcoming the blood-brain barrier.
To date, congenital syphilis is extremely rare. Due to the fact that a system has been established for the early detection and treatment of syphilis in the early stages, there has been a sharp drop in incidence rates. A strict record of patients with congenital syphilis is kept.
The prevention of cases of congenital syphilis in the first place include measures for the timely treatment of acquired infections. All pregnant women should undergo the necessary studies, including analysis of serological reactions twice during pregnancy.
If syphilis is detected during gestation, the expectant mother should undergo a full course of antisyphilitic therapy, since this greatly reduces the likelihood of the development of pathology in the fetus during the formation period.
Pregnant women with a history of syphilis are prescribed prophylactic treatment, regardless of whether the appropriate therapy was carried out and how successful it was.
If there is evidence that the expectant mother was not fully cured of syphilis, the child is prescribed antisyphilitic treatment, regardless of the presence of signs of the disease and negative serological reactions.
Symptoms of Late congenital syphilis:
Late congenital syphilis (syphilis congenita tarda)
Clinical symptoms occur not earlier than 4-5 years of age, can be observed on the 3rd year of life, but more often - at the age of 14-15, and sometimes later. Most children have early congenital syphilis without symptoms (early latent congenital syphilis) or even early latent syphilis may be absent, others show characteristic changes in early congenital syphilis (saddle nose, Robinson – Fournier scars, skull deformity). In late congenital syphilis, bumps and gum appear on the skin and mucous membranes, numerous visceropathies, diseases of the central nervous system, and endocrine glands are noted. The clinical picture of late congenital syphilis does not differ from that of the tertiary period of syphilis. There is a diffuse seal liver. Much less likely to appear gummy nodes. Damage to the spleen, as well as nephrosis, nephrosonephritis. With involvement in the pathological process of the cardiovascular system, heart valve insufficiency, endocarditis, and myocarditis are detected. There is evidence of lesions of the lungs, digestive tract. Typical is the defeat of the endocrine system (thyroid, adrenal glands, pancreas and genital glands).
Characteristic features of the clinical picture of late congenital syphilis are specific symptoms, which are divided into unconditional (reliably indicate congenital syphilis) and probable (require additional confirmation of the diagnosis of congenital syphilis). There is also a group of degenerative changes, the presence of which does not confirm the diagnosis of syphilis, but which should be excluded.
Parenchymal keratitis (keratitis parenchymatosa). As a rule, initially one eye is involved in the pathological process, after 6-10 months - the second. Regardless of treatment, signs of parenchymal keratitis (diffuse opacification of the cornea, photophobia, lacrimation, blepharospasm) are noted. Corneal opacification is manifested more intensely in the center and often develops not in a diffuse manner, but in separate sections. Prikornealny vessels and vessels of a conjunctiva are expanded. Visual acuity decreases and often disappears. At the same time, other eye lesions can be observed: iritis, chorioretinitis, optic nerve atrophy. The prognosis for vision restoration is unfavorable. Almost 30% of patients have a significant decrease in visual acuity.
Dental degeneration, Getchinson teeth (dentes Hutchinson). First described by Getchinson in 1858 and manifest hypoplasia of the chewing surface of the upper middle permanent incisors, along whose free edge semilunar, crescent-shaped grooves are formed. The neck of the tooth becomes wider ("barrel-shaped" teeth or in the form of a "screwdriver"). Enamel on the cutting edge is missing.
Specific labyrinthitis, labyrinth deafness (surditas labyrinthicus). It is observed in 3-6% of patients aged 5 to 15 years (more often in girls). Due to inflammation, hemorrhages in the inner ear, dystrophic changes of the auditory nerve, deafness suddenly occurs due to damage to both nerves. In the case of development up to 4 years of age, it is combined with difficulty in speaking, even to silence. Bone conduction is impaired. Differs in resistance to specific therapy.
It should be noted that all three significant symptoms of late congenital syphilis — the Getchinson triad — are at the same time quite rare.
They are taken into account in the diagnosis, provided that other specific manifestations, anamnesis data and the results of the examination of the patient's family are detected.
Specific drives, first described by Cletton in 1886, occurs in the form of chronic synovitis of the knee joints. The clinical picture of cartilage damage to the epiphyses is absent. On examination, an increase in the joint, its swelling, limited mobility, painlessness are noted. Perhaps a symmetrical lesion of the other joint. Often, the elbow and ankle joints are involved in the pathological process.
Bones are often affected with a predominance of hyperplastic processes in the form of osteoperiosteum and periostitis, as well as gummous osteomyelitis, osteosclerosis. Characterized by the destruction of the bone in combination with the processes of hyperplasia. Due to inflammation, increased bone growth occurs. Quite often there is a symmetrical lesion of long tubular bones, mostly tibial: under the weight of a child, the tibia bent forward, “saber tibias” (tibia syphilitica) develop, which is diagnosed as a consequence of syphilitic osteochondritis transferred during infancy. As a result of the postponed syphilitic rhinitis, an underdevelopment of the bone or cartilaginous parts of the nose is noted, characteristic organ deformities appear.
Saddle nose observed in 15-20% of patients with late sun. Due to the destruction of the nasal bones and nasal septum, the nostrils protrude.
Goat and lornetoid nose formed as a result of small-cell diffuse infiltration and atrophy of the nasal mucosa, cartilage.
Buttock-shaped skull. The frontal hillocks will stand as if separated by a furrow, which is due to syphilitic hydrocephalus and osteoperiosteitis of the bones of the skull.
Dystrophic lesions of the teeth. Atrophy of the contact part and underdevelopment of the chewing surface is noted on the first molar. The shape of the tooth resembles a tobacco pouch (Moon's tooth). The chewing surface can also be changed to 2 and 3 molars (Moser and Pfluger teeth). Instead of a normal chewing tubercle, a thin conical process (Fournier's goose tooth) is formed on the surface of the canine.
Robinson radial scars - Fournier. Around the corners of the mouth, lips, on the chin are the radial scars, which are the result of congenital syphilis transferred in chest or early childhood - diffuse papular infiltration of Gohsinger.
Nervous system damage often observed and manifested by mental retardation, speech disorder, hemiplegia, hemiparesis, dorsal taboo, Jacksonian epilepsy (convulsive twitching of one half of the face or limb due to the occurrence of gum or limited meningitis).
Specific retinitis. Affected choroid, retina, nipple of the optic nerve. In the fundus, a typical pattern of small pigmented lesions in the form of "salt and pepper" is revealed.
Dystrophy (stigma) sometimes indicate congenital syphilis. Can be a manifestation of syphilitic lesions of the endocrine, cardiovascular and nervous systems:
- high (“lancet” or “gothic”) hard palate,
- dystrophic changes of the bones of the skull: frontal and parietal bumps protruding forward, but without a separating groove,
- additional Karabelli tubercle: an additional tubercle appears on the inner and lateral surface of the upper molars,
- absence of the xiphoid process of the sternum (aksifoidiya),
- infantile little finger (symptom of Dubois - Gissard) or shortening of the little finger (symptom of Dubois),
- widely spaced upper incisors (Gachet symptom).
- thickening of the sternoclavicular joint (symptom of Austidia),
- Hypertrichia can be observed in both girls and boys. Often marked overgrowing of the forehead with hair.
Treatment of Late congenital syphilis:
Treponema pallidum is actually the only microorganism that has survived to the present, despite decades of penicillin therapy, a unique high sensitivity to penicillin and its derivatives. It does not produce penicillinases and does not have other anti-penicillin protection mechanisms (such as mutations of cell wall proteins or a gene of polyvalent drug resistance), long developed by other microorganisms. Therefore, today the main method of modern antisyphilitic therapy is the long-term systematic administration of penicillin derivatives in sufficient doses.
And only if the patient is allergic to penicillin derivatives or if the pale treponema strain isolated from the patient is confirmed to the penicillin derivative, an alternative treatment regimen — erythromycin — can be recommended (other macrolides are probably also active, but their effectiveness has not been documented by the instructions of the Ministry of Health, and therefore not recommended), or tetracycline derivatives, or cephalosporins. Aminoglycosides suppress the reproduction of pale treponema only in very high doses, which have a toxic effect on the host organism, therefore the use of aminoglycosides as monotherapy for syphilis is not recommended. Sulfonamides with syphilis are generally not effective.
In neurosyphilis, a combination of oral or intramuscular administration of antibacterial drugs with their endolyumbal administration and pyrotherapy, which increases the permeability of the blood-brain barrier for antibiotics, is mandatory.
In the case of widespread tertiary syphilis against the background of pronounced resistance of pale treponema to antibacterial drugs and in good general condition of the patient, allowing for some toxicity of the therapy being carried out, addition of bismuth derivatives (biiyoquinol) or arsenic derivatives (Miarsenol, novarsenol) to antibiotics can be recommended. Currently, these drugs are not available in the general pharmacy chain and are available only to specialized institutions in limited quantities, since they are highly toxic and are rarely used.
При сифилисе следует обязательно провести лечение всех половых партнеров больного. В случае больных с первичным сифилисом лечению подвергаются все лица, имевшие половые контакты с больным в течение последних 3 месяцев. In the case of secondary syphilis, all persons who have had sex with a patient in the last year.
Forecast The disease is mainly determined by the rational treatment of the mother and the severity of the child’s illness. As a rule, early treatment, good nutrition, careful care, breastfeeding contribute to the achievement of favorable results. The timing of the start of treatment is of great importance, since specific therapy started after 6 months is less effective.
In recent years, in infants with congenital syphilis, as a result of the full course of treatment, standard serological reactions become negative by the end of the 1st year of life, with late congenital syphilis - much later, and RIF and RIBT may remain positive for a long time.
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What triggers late congenital syphilis
Congenital syphilis develops when pale treponema enters the fetus through the umbilical vein or through the lymphatic crevices from a syphilis-infected mother. The fetus may become infected in case of illness of the mother before pregnancy, as well as at different stages of its development. Pathological changes in the organs and tissues of the fetus develop in the 5th-6th months of pregnancy, i.e. during the development of placental circulation.
Pathogenesis (what is happening?) During Late congenital syphilis
According to a number of scientists, syphilitic infection can also affect the chromosomal apparatus of the germ cells of the parents. There are syphilitic gametopathies (degenerative changes that have occurred in germ cells before fertilization), blastopathy (defeat of the embryo during blastogenesis) and syphilitic embryopathies (pathological changes of the fetus from 4 weeks to 4-5 months of pregnancy). Such sick children show various defects of a physical, neurological and mental, intellectual nature.
Congenital syphilis occurs as a result of pale treponema in the fetus through the placenta from the mother suffering from syphilis. Infection of the fetus can occur both in the case of mother’s illness before conception, and later, at different stages of fetal development. Pale treponemas enter the fetus through the umbilical vein or through the lymphatic crevices of the umbilical vessels. Despite the early penetration of pale treponema into the fetus, pathological changes in its organs and tissues develop only in the 5th-6th months of pregnancy. Therefore, active antisyphilitic treatment in the early stages of pregnancy can ensure the birth of healthy offspring. Since secondary syphilis occurs with symptoms of spirochemia, the greatest risk is the birth of a sick child in pregnant women suffering from secondary syphilis. In addition, the transmission of syphilis to offspring occurs mainly in the first years after infection of the mother, later this ability gradually decreases. It is considered possible to give birth to syphilis-infected children from a mother suffering from congenital syphilis (syphilis of the second and even third generation). However, such cases are very rare. The outcome of pregnancy in a woman with syphilis is different: it can result in late miscarriage, premature birth, the birth of sick children with early or late manifestations of the disease or latent infection. For women with syphilis, there is a different outcome of pregnancy at different stages of the process, since the degree of infection of the fetus depends on the activity of the infection. The possibility of infection of the fetus by transmission of infection through the sperm from the father has not yet been proven.
Types of congenital syphilis
The age at which the disease manifests itself is based on the classification of congenital syphilis found in children. The range is quite wide: from chest to adolescence.
For further prognosis, the time of manifestation of specific lesions is of great importance: the earlier symptoms are detected, the more favorable they are. Doctors diagnose the following forms of the disease.
Early congenital syphilis
- Fetal syphilis
Most often, doctors diagnose early congenital syphilis of the fetus, when intrauterine infection occurs. If this happens at 5-6 months, preterm labor can begin. The baby is usually born dead, macerated (flabby, swollen, loose body), with pathologies of the lungs, spleen, liver.
- Infant syphilis
If the infection of the mother occurred in late pregnancy, the symptoms of the disease appear after the birth of the baby. In the diagnosis of syphilis in infancy, the Wasserman reaction is detected only in the 3rd month of a newborn's life.
- Early childhood syphilis
About this form of the disease say, if it manifested itself at the age of 1 year to four years.
Hidden congenital syphilis
This form of the disease can be observed in a child at any age. Its difficulty is that it usually occurs in the absence of symptoms. Therefore, latent congenital syphilis can be detected only as a result of serological studies (carried out on the basis of biological material, most often - cerebrospinal fluid).
All these forms of congenital syphilis do not pass without a trace. Among the most dangerous consequences are disability and lethality. The symptomatology of the latent disease allows the child to live to a certain point, and he will not differ from his peers in his development. However, you need to understand that someday the infection will still manifest.
Through the pages of history. Syphilis was given its name in 1530 by an Italian poet and part-time doctor by the name of Girolamo Frakastoro.
Causes of disease
Pale treponema infects the fetus, penetrating into the placenta through the lymphatic crevices of the blood vessels or the umbilical vein. It is given to a child from a mother who has syphilis. Children are at risk if:
- infection of the woman occurred before conception,
- infection was diagnosed at different stages of pregnancy,
- the mother is ill with secondary or congenital syphilis.
Transmission of bacteria from mother to child occurs in the first years of infection, when the stage of the disease is active. With age, this ability gradually weakens.
If a woman suffers from a chronic form, but is constantly being treated, she may well have a healthy baby. Therefore, it is necessary to constantly undergo special examinations and carefully monitor the condition of the fetus during its prenatal development, and then its health in the future, in time to reveal even the latent form of the disease. For this, it is necessary to know the clinical picture of the course of the infection, i.e., its symptoms.
Keep in mind! The transmission of infection to the fetus from sperm is not scientifically proven, so there is no point in blaming the father for congenital syphilis of the child.
Since there are chances for a healthy baby to appear, if the mother is infected, it is necessary to identify the signs of congenital syphilis in time at the stage of fetal development. This will allow to take the necessary measures, find out the degree of infection activity and make at least some predictions for the future. The symptomatology of the disease is very diverse and depends largely on the stage at which it is detected, that is, on its form.
Symptoms of congenital fetal syphilis
- Big sizes of a fruit,
- low body weight
- maceration (swelling, friability),
- enlarged liver, its atrophy,
- enlarged, compacted spleen,
- underdeveloped buds covered with a crust
- stomach ulcers,
- damage to the central nervous system, brain.
Symptoms of congenital syphilis in infancy
- Dry, wrinkled face,
- large head with strongly developed bumps on the forehead, pronounced venous network, seborrheic crusts,
- pigmentation on the face,
- sunken bridge,
- pale, dirty yellow, loose skin,
- thin, blue limbs,
- the child is restless, constantly crying, does not sleep well, screams,
- poor development
- weight loss,
- persistent runny nose, which causes difficulty breathing and sucking,
- dystrophy with complete lack of fatty subcutaneous tissue,
- over time, bedsores are formed,
- syphilitic pemphigus on the palms, soles, face, elbows, knees: vesicles of large size with purulent contents,
- epidemic pemphigus - large bubbles merging with each other, bleeding, eroded, accompanied by high fever, diarrhea, green stools,
- diffuse compaction of the skin - scaly erosion on the palms, face, soles, head, accompanied by loss of hair and eyebrows, swelling of the lips, cracks in the corners of the mouth, crusts on the chin, ulcers on the entire surface of the body,
- heels redness,
- papular syphilide - the formation of copper-red papules and age spots,
- roseola rash - individual scaly brownish stains with a tendency to merge,
- syphilitic baldness - hair loss, eyelashes, eyebrows,
- syphilitic rhinitis - hypertrophy of the mucous membrane of the nose, mouth, larynx,
- Wegner's syphilitic osteochondritis is a pathological lesion of the skeletal system, which often leads to a false paralysis, when the upper limbs hang with whips, the lower ones are constantly bent at the knees,
- defeat of the joints in congenital syphilis in an infant child is expressed by a movement disorder, complete immobility of the limbs,
- eye damage - sometimes the only sign of congenital syphilis: the fundus of the eye is pigmented, later - loss of vision, keratitis.
Symptoms of young congenital syphilis
- The skin of the genitals, groin, anus, interdigital folds of the legs are affected by limited large weeping papules,
- roseolous eruptions
- buns in the corners of the mouth,
- papules on the mucous larynx merge, causing a hoarse, husky voice, aphonia, laryngeal stenosis,
- syphilitic rhinitis,
- swollen lymph nodes
- periostitis, osteoperiostity, osteosclerosis - pathological damage of the skeletal system,
- enlargement, hardening of the spleen and liver,
- nephrosonephritis (kidney dystrophy),
- enlargement, induration of the testes,
- As a result of the nervous system damage, mental retardation is often diagnosed in congenital syphilis, as well as epileptiform seizures, hydrocephalus, hemiplegia (paralysis of one part of the body), meningitis,
- eye lesions: horitinitis, optic nerve atrophy, keratitis.
Symptoms of late congenital syphilis
- Reliable signs
- Keratitis is a pathological inflammation of the cornea of the eye, which is accompanied by clouding of the mucous membrane in individual areas, photophobia, tearing, blepharospasm, decrease in visual acuity, atrophy of the optic nerve up to complete blindness,
- dental degeneration,
- specific labyrinthitis - deafness, combined with difficulty of speech, may occur dumbness.
- Likely signs
- Specific drives - the defeat of the knee joints, which increase, swell, ache,
- defeat of the bones leads to the fact that the symptoms of late congenital syphilis are visible to the naked eye: the lower legs become saber-like, and the baby’s gait changes greatly,
- saddle nose,
- buttock-shaped skull
- tooth degeneration,
- Radar scars, which are called Robinson-Fournier, near the mouth, chin,
- due to severe damage to the central nervous system, oligophrenia is possible in congenital syphilis, as well as epilepsy and speech disorder,
- specific retinitis,
- dystrophy (stigma).
The outward manifestation of congenital syphilis in a child rarely goes unnoticed, unless it is a latent form of the disease. Damages of internal organs and systems are so powerful and extensive that even in infancy the symptoms are noticeable even with the naked eye. They are difficult to confuse with the signs of other diseases, especially since the infection of a baby is most often spoken during pregnancy.
It is especially important for parents to know how congenital syphilis manifests itself in adolescence (i.e., later), since at the beginning of the child’s life he didn’t see himself externally, while the harmful bacterium destroyed his tissue. Under laboratory conditions, the diagnosis is refuted or confirmed fairly quickly.
Important information. If the latent form of congenital syphilis is not cured in time, the matured child will be a living carrier of pale treponema, infecting other people with it.
Forecasts for the future of a child with congenital syphilis can be very different. From the risk of dying still in the womb until full recovery after birth. At the stage of pregnancy and subsequently there are many concerns:
- late miscarriage
- preterm labor,
- the birth of a dead baby.
It is impossible to predict what will happen in this or that case. The different outcome of pregnancy depends on numerous factors: the stages of the process, the treatment that the mother has undergone or is still taking place, the degree of intrauterine infection of the fetus, the activity of the infection and much more.
Given the modern medical technologies that are used to treat congenital syphilis, with good nutrition, careful care of the baby, breastfeeding can hope for positive results and recovery.
The timing when therapy was started is very important. In infants with this disease, standard serological reactions are restored by the first year of life. With late congenital syphilis, they become less rare.
If the disease was detected in a timely manner, treatment of congenital syphilis in infants gives positive results. The later the diagnosis was made, as well as the latent form of the infection, the consequences for the health and life of the child may be the most unfavorable, even fatal. Treatment includes drug therapy and proper care.
- Vitamin therapy,
- injections of penicillin and its derivatives (ecmonovocillin, bicillin),
- bismuth (if the child is more than half a year),
- if the child is allergic to penicillin - erythromycin, tetracycline, cephalosporins,
- the combination of muscle administration of antibacterial drugs with endolyumbal injection (into the spine) and pyrotherapy (artificial fever),
- arsenic derivatives (mimarsenol, novarsenol),
- biogenic stimulants.
- Regular hygiene procedures, since the child’s skin is primarily affected by this disease,
- good nutrition, which should include foods high in vitamins and proteins,
- day regimen with meals at the same time, night sleep for at least 9 hours, as well as daytime sleep,
- daily walks or at least outdoor activities,
- regular resort specific treatment,
- constant monitoring and visits to relevant doctors.
In case of detection of congenital syphilis of any form and stage for the treatment of the patient is placed in the hospital venereal dispensary.
If a woman underwent appropriate treatment during pregnancy and the body of the newborn received all the necessary procedures in the first month of her life, the disease does not constitute a threat to the future life of the child. If the diagnosis was made later, with latent forms and late stage therapy may not give results. In this case, the consequences may be the most undesirable.
Syphilis is one of the most common sexually transmitted diseases. Along with gonorrhea, chlamydia, cytomegaly and trichomoniasis, it is a sexually transmitted infection. In addition to the sexual mode of transmission, infection can occur in utero and lead to the development of congenital syphilis. A child with congenital syphilis is an infectious danger to others, especially if the disease occurs with skin manifestations.
Causes of congenital syphilis
The disease of the child with congenital syphilis is due to the transmission of infection from the sick mother to the period of intrauterine development. Treponema pallidum (causative agent of syphilis) is not able to pass through a healthy transplacental barrier. However, syphilis in women during pregnancy leads to the defeat of the placenta and causes a violation of its protective barrier function. As a result, treponema enter the body of the fetus.
Transmission of treponem from the mother to the fetus is most likely in the early years of the mother’s illness, with time this ability fades away. The risk of having a child with congenital syphilis is especially great in women with a secondary form of this disease, accompanied by dissemination of the pathogen with blood flow. In fetal-infected fetuses, internal organ damage develops only in the 5-6th month of pregnancy. Therefore, early antisyphyllitic treatment can lead to the birth of a healthy child.
Symptoms of congenital syphilis
Depending on the characteristics of congenital syphilis and the timing of the appearance of its clinical signs, venereology identifies 4 main forms of the disease.
Fetal syphilis develops during the prenatal period, but not earlier than the 5th month of pregnancy. It is characterized by compaction and enlargement of internal organs (especially the liver and spleen), occurring due to their inflammatory infiltration. The formation of infiltrates in the lungs leads to the development of "white" pneumonia of the fetus. The most reliable criterion confirming fetal congenital syphilis is X-ray detection of signs of specific osteochondrosis in the fetus. The occurrence of congenital syphilis in the period of prenatal development can cause premature birth, late miscarriage, stillbirth or the birth of a sick child.
Early congenital syphilis manifests itself in a child under the age of 2 years and is divided into congenital syphilis of infancy and syphilis of early childhood. In infants, symptoms of congenital syphilis may appear during the first 1-2 months of life. Most often it is a lesion of the skin and mucous membranes with the development of a syphilitic pemphigus.
Typical symptoms of congenital syphilis in infants are also syphilitic rhinitis and Gochzinger infiltration. Syphilitic rhinitis has a long course with pronounced swelling of the mucous membranes, copious mucous discharge, pronounced difficulty of nasal breathing. It can lead to the defeat of the bone and cartilaginous structures of the nose with the formation of a saddle deformity. Gohsinger's infiltration is expressed by the appearance, on the 8th-10th week of life of a child with congenital syphilis, of a dense infiltrate (syphilide), which is located in the chin and lips, on the soles, buttocks and palms. The child’s lips are thickened and swollen, crack and bleed, the skin of the affected areas loses its elasticity, thickens, and its folds are smoothed out.
In congenital syphilis of infancy, ulcerative lesion of the larynx may occur with the occurrence of hoarseness. Bone tissue lesions are manifested by osteochondritis and periostitis of predominantly long tubular bones. As with secondary syphilis, specific lesions of somatic organs caused by congenital syphilis can be observed: hepatitis, myocarditis, pericarditis, endocarditis, glomerulonephritis, hydrocephalus, meningitis, meningoencephalitis. Boys often have specific orchitis, and sometimes testicular dropsy. The defeat of the lungs in congenital syphilis occurs with the development of interstitial diffuse pneumonia, which often leads to the death of the child in the first days of life.
In early childhood congenital syphilis can manifest eye diseases, damage to the nervous system and limited skin manifestations in the form of a few large papules and wide warts. In congenital syphilis in young children, lesions of the internal organs are less pronounced. Changes in bone tissue are detected only on radiographs.
Late congenital syphilis begins to manifest itself clinically after 2 years of age, most often in adolescence (14-15 years). Its symptoms are similar to the picture of tertiary syphilis. These are gummy or bumpy syphilides localized on the body, face, limbs, nasal mucosa and hard palate. They quickly decay with the formation of ulcers. The common symptoms of late congenital syphilis include specific drives, saber tibias, and dystrophic changes (stigmas) due to the influence of the pathogen on the forming tissues and organs. Stigmas are non-specific and can occur in other infectious diseases (for example, in tuberculosis). Specific for late congenital syphilis is Getchinson's triad: syphilitic labyrinthitis, diffuse keratitis and Getchinson teeth - dystrophic changes in the central upper incisors.
Hidden congenital syphilis can be observed in a child at any age. It occurs in the complete absence of clinical symptoms and is detected only by the results of serological studies.
Treatment of congenital syphilis
Pale treponema, unlike most other microorganisms, still remains highly sensitive to the effects of penicillin antibiotics. Therefore, the main therapy of congenital syphilis consists in the prolonged systemic administration of penicillins (benzylpenicillins in combination and in combination with ecmoline). If a child has an allergic reaction to penicillin or reveals the stability of treponema according to the results of bakposev with an antibiogram, the treatment is carried out with erythromycin, cephalosporins or tetracycline derivatives.
With the defeat of congenital syphilis of the nervous system with the development of neurosyphilis, endolyumbal administration of antibiotics and pyrotherapy (prodigiosan, pyrogenal) have been shown, improving their penetration through the hemato-encephalic barrier. In the treatment of late congenital syphilis, along with antibiotic therapy, bismuth preparations (bismoverol, bijohinol) are prescribed. Vitamins, biogenic stimulants, and immunomodulators are also used.
The dangerous consequences of congenital syphilis for the further health of infected children will depend entirely on the timely course of treatment and the form of the disease. In most cases, they still manage to avoid.
In the absence of specific, timely treatment, the child may remain disabled for life or die due to the injury of too many internal organs, systems, and tissues.
Untreated, advanced congenital syphilis can lead to:
- mental and physical retardation,
- external deformities in the form of deformation of the skull, limbs, teeth, nose,
- loss of sight
- impotence in the future in boys and sterility in girls.
All these are symptoms of congenital syphilis, which, with inadequate treatment, progress and cause serious pathologies. As a result, irreversible processes lead to a child’s disability for life.
Dangerous consequences, like the disease itself, can be easily avoided if preventive measures are taken on time.
The basic principle of the classification of congenital syphilis is based on the stages of the disease in a child. The possible range of manifestations of the first signs varies considerably: from the period of infancy to the pubertal age.
Variations of the possible outcome of the disease are largely dependent on the timeliness of detection of the disease. The sooner the first signs are noticeable, the better.
In medical practice, the forms are diagnosed:
- Early congenital syphilis - it is called fetal syphilis. In this case, the infection occurs at the intrauterine stage. If pathology was detected in the second trimester of pregnancy, there is a risk of premature termination of pregnancy. You need to pay attention to the fact that the cause of miscarriage in 5-6 months of pregnancy often consists of STDs.
- Syphilis infancy. It is possible if the infection of the mother occurred in the last stages of gestation. The difficulty lies in the fact that the reaction of Vesserman is informative only with 3 months of life crumbs.
- Syphilis of early childhood is diagnosed if the disease manifested itself at the age from 1 to 4 years.
- Late congenital syphilis is diagnosed at puberty, while it does not manifest itself to a certain stage. The danger for an imperfect organism is that it is a relapse of a dangerous and unrevealed pathology.
- Hidden congenital syphilis - manifested in a child at any age, while proceeding in a latent form to a certain stage. The reaction of Vesserman in this case can be false negative. The only possible method of detection is a serological test, the material used is cerebrospinal fluid.
The course of the disease in the latent form allows the child to live to a certain point. Such a member of society will not differ from others and will live a normal life. It is important to remember that all forms of syphilis are dangerous and can cause disability or death.
In the case of infection in the prenatal stage of a living child, the diagnosis is determined - syphilis of infancy. It is found in babies whose age is up to a year.
The period of the violence of the microorganism proceeds in two stages:
- Up to 3-4 months. Manifestation of dermatological defects on the mucous membranes and skin. Essential lesions of the internal organs (liver, spleen and nervous system) are diagnosed.
- Starting from the 4th month. The main symptoms of the disease subside. Separate rashes appear on the skin, gum forms in the bones. The defeat of the central nervous system and other internal organs are diagnosed less frequently.
Manifestations of the disease can be recorded during the first 2 months. It is important to note that they are extremely contagious.
In recent decades, children are diagnosed with syphilis, which occurs in a latent form, this is primarily due to the use of antibacterial drugs.
Among the symptoms of early congenital syphilis are:
- skin infiltration
- syphilitic rhinitis,
Such patients slowly gain weight, lag behind their peers in development, are more restless (often crying) and sleep poorly.
Chances of having a healthy baby have a woman infected with syphilis. In order to not miss this opportunity, attention should be paid to timely diagnosis, medical tests should not be neglected.
Symptoms pathologists are largely diverse, but they are completely dependent on the type of disease.
Among the list of symptoms of congenital syphilis of the fetus are:
- substantial size of the fetus in combination with low body weight,
- swelling and friability of the skin,
- atrophy of the liver or its deformation,
- seals in the spleen,
- ulceration in the stomach
- brain damage.
The symptoms of congenital syphilis of the chest period include:
- Dry skin of the face, the appearance of wrinkles.
- Increased head size, manifestation of the venous network on the forehead and seborrheic formations on the hairy areas.
- The fall of the nose.
- Unhealthy skin color, from jaundiced to dirty green.
- Rapid weight loss, thin limbs, developmental lag from peers.
- Inability to grasp the nipple, arising against the background of permanent rhinitis.
- The manifestation of syphilitic pemphigus.
- Redness heels.
- Diffuse formations on the skin.
- Syphilitic baldness.
- Damage to the eyes and joints.
Among the characteristic signs of syphilis in young age are:
- the formation of weeping papules in the genital area,
- non-healing bunches in the corners of the mouth,
- syphilitic rhinitis,
- swollen lymph nodes
- bone damage,
- renal dysfunction,
- lesions of the nervous system, provoking mental retardation,
- atrophy of the optic nerve.
The clinical symptoms of congenital syphilis go unnoticed extremely rarely, that is, this is possible only in cases where the disease is in a latent form. Damages of internal organs are shown by swiftness, especially in infants.
Attention! If therapeutic measures are not promptly taken to treat a latent form of syphilis, in adulthood the baby will become a carrier of pale treponema and become a source of microorganism for other people.
Signs of the disease are difficult to confuse with other types of abnormalities, because a woman learns about the risk of infection of the fetus during pregnancy. It is important for parents to familiarize themselves with the main symptoms of the disease, to learn diagnostic methods that help identify or refute the presence of pale treponemas.
The disease can be detected in the mother at any stage of pregnancy.
To confirm or refute the diagnosis of a child at the prenatal stage of development, various methods are used, including:
- X-ray examination. The technique allows to confirm or refute the presence of periosteum deformities or bone inflammation in a timely manner.
- Serological reactions involve the introduction of antigen into the bloodstream and study the reaction of the body.
It is necessary to examine the child with the following specialists:
- gynecologist (for girls).
Subject to timely therapeutic measures taken, proper care and completion of the full course of therapy, the outcome for the child can be favorable.
Complications of syphilis
Congenital syphilis which symptoms can frighten often manifest at different periods of life. Projections on the outcome of the pathology can be very diverse. Possible death of the child in the neonatal period or complete recovery after the course of therapy.
Even during pregnancy, there are many dangers for an infected mother. With accuracy to predict the possible outcome of pregnancy is simply impossible.
Modern methods of complete treatment suggest:
- thorough care for baby
- replacement of breast milk of an infected mother with an adapted mixture,
- consumption of essential drugs and vitamin complexes.
It is extremely important to remember the main condition - the earlier the pathology is revealed, the higher the chances of success. With congenital syphilis, timely diagnosis plays an important role.
Early congenital syphilis can be cured, for this you need to comply with all the requirements of the doctor.
Methods of therapy
If the signs of congenital syphilis are identified in a timely manner, and the drugs for its treatment are selected, surely, then treatment with a high degree of probability will give a positive result.
Drug therapy involves the mixing of several groups of products whose action is aimed at improving the patient's condition:
- Reception of a complex of vitamins.
- The introduction of antibiotics penicillins.
- Bismuth preparations.
- If you are allergic to penicillin, antibacterial agents of other groups are used.
- Use of biogenic stimulants.
- The use of immunomodulators.
Treatment involves proper care:
- skin care,
- breastfeeding rules,
- dietary control
- respect for sleep and wakefulness,
- establishment of drinking regime,
- daily walks in the fresh air
- stay with specialists.
Attention! The treatment of syphilis, regardless of the form and stage of the pathological process, occurs in the inpatient setting of the venereology department.
If an infection in a pregnant woman was detected before the 5th month of pregnancy, effective prevention of the disease is possible, since pathological changes in the tissues and organs do not occur in the early stages. After completing a full course of drug exposure, there is no threat to the fetus.
Diagnostic manipulations allow you to identify the disease at the prenatal stage and carry out treatment that allows you to minimize the existing risks to the fetus.
Women should keep in mind that sexually transmitted diseases can be treated on condition of timely treatment to a doctor.
You should not be embarrassed at the time of passing the diagnostic test, because only these measures will allow you to save your own health and give birth to a baby.
Using barrier methods of contraception can reduce the risk of infection in the body, but 100% protection is still impossible.