Çelik Muhittin, Bülbül Ali, Uslu Sinan
Department of Pediatrics, Division of Neonatology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
Sisli Etfal Hastan Tip Bul. 2020 Mar 25;54(1):113-116. doi: 10.14744/SEMB.2018.22605. eCollection 2020.
Congenital syphilis is a severe disease that arises from the vertical transmission of Treponema pallidum. Clinical findings are related to the pregnancy stage, fetal gestational week, maternal treatment and fetal immunologic response. Prematurity, low birth weight, nonimmune hydrops fetalis, necrotizing enterecolitis, hepatomegaly, skin eruptions, thrombocytopenia, hemolytic anemia and fever can be detected in the symptomatic newborn. Postnatal respiratory insufficiency, hepatomegaly, anemia and thrombocytopenia were detected in a baby who was born at the 29 week of gestation, weighing 1.160 g and followed due to intestinal hyperechogenicity from the second trimester. Her and her mother's Venereal Disease Research Laboratory titers were positive, confirming test Treponema pallidum hemagglutination was reactive. After penicillin was administered for 10 days, anemia, and thrombocytopenia were regressed. In the 15 day of life, findings of perforated necrotising enterocolitis (NEC) suddenly appeared. The operation was performed due to NEC for three times but nonresponsive laboratory and clinical findings and died in the 54 day of life. We assumed that syphilis is the cause of both bowel hyperechogenicity and necrotising enterocolitis.
先天性梅毒是一种由梅毒螺旋体垂直传播引起的严重疾病。临床症状与妊娠阶段、胎儿孕周、母亲治疗情况及胎儿免疫反应有关。有症状的新生儿可出现早产、低出生体重、非免疫性胎儿水肿、坏死性小肠结肠炎、肝肿大、皮疹、血小板减少、溶血性贫血和发热等症状。一名妊娠29周出生、体重1160克的婴儿,因孕中期肠道回声增强而接受随访,出生后出现呼吸功能不全、肝肿大、贫血和血小板减少。她和她母亲的性病研究实验室滴度呈阳性,梅毒螺旋体血凝试验确诊试验呈阳性反应。使用青霉素治疗10天后,贫血和血小板减少症状有所缓解。出生后第15天,突然出现坏死性小肠结肠炎(NEC)穿孔的症状。因NEC进行了三次手术,但实验室检查和临床症状均无改善,患儿于出生后第54天死亡。我们推测梅毒是肠道回声增强和坏死性小肠结肠炎的病因。