Pediatric Department, Tergooi locatie Blaricum, Blaricum, Netherlands; Department of Pediatric Immunology, Rheumatology, and Infectious Diseases, Amsterdam UMC, locatie AMC, Amsterdam, Netherlands.
Pediatric Department, Tergooi locatie Blaricum, Blaricum, Netherlands.
Lancet Infect Dis. 2020 Jul;20(7):e173-e179. doi: 10.1016/S1473-3099(20)30268-1. Epub 2020 Jun 2.
Syphilis is caused by a spirochaete bacterium called Treponema pallidum. Vertical transmission of spirochaetes can lead to congenital infection of the fetus in pregnant women who are inadequately treated or not treated at all, causing various clinical manifestations including stillbirth and neonatal death, cutaneous and visceral manifestations, or asymptomatic infection. We present a severe case of syphilis in a 3-month-old boy with skin lesions, portal hypertension, and anaemia. Because the mother was tested negative for syphilis antibodies at 16 weeks of gestation, a diagnosis of congenital syphilis was initially not considered. This case shows that transmission of T pallidum can still occur in high-income countries with a high rate of antenatal screening. Early recognition might be hampered if physicians do not consider congenital syphilis as a possible diagnosis. Congenital syphilis should be considered in any severe and diagnostically challenging infectious disease case, even in the context of negative antenatal screening.
梅毒由一种叫做苍白密螺旋体的螺旋体细菌引起。未经治疗或治疗不充分的孕妇垂直传播螺旋体可导致胎儿先天性感染，引起各种临床表现，包括死产和新生儿死亡、皮肤和内脏表现或无症状感染。我们报告了一例 3 个月大男婴的严重梅毒病例，该患儿有皮肤损伤、门静脉高压和贫血。由于母亲在妊娠 16 周时梅毒抗体检测阴性，最初并未考虑先天性梅毒的诊断。该病例表明，即使在产前筛查率高的高收入国家，梅毒螺旋体仍可能传播。如果医生不考虑先天性梅毒作为可能的诊断，可能会阻碍早期识别。即使在产前筛查阴性的情况下，对于任何严重且具有诊断挑战性的传染病病例，都应考虑先天性梅毒。
