Abstract
Background.Congenital syphilis is a severe intrauterine infection which, affecting most of the organs and systems of a child, can lead to his disability. However, it is extremely difficult to suspect congenital syphilis in a child in the absence of information about prior syphilis in his mother. The article presents a case of a monosymptomatic clinical picture of early congenital syphilis.Description of the Clinical Case. At the age of 1 month, the child had hyperemia, isolated edema of the right forearm, and restriction of limb movements. He was examined by a pediatrician who suspected a fracture of the forearm bones. X-ray did not show any fracture. The situation was regarded as an allergic reaction; desensitizing therapy was prescribed during which the range of movements in the right arm slightly increased. At the age of 2 months, there was a decrease in the range of movements in the left arm. On admission, the condition was regarded as moderate one. No fever; no signs of intoxication. Skin and visible mucous membranes were not changed. Cardiopulmonary activity was satisfactory. The abdomen was palpable in all compartments, painless. The liver was enlarged 6 cm, of dense consistency. The spleen was enlarged 5 cm. Bowel and bladder functions were normal. Neurological status: the reaction to examination was adequate, emotional cry. Cranial nerves without pathology. Can see and hear. Restricted range of movements in the arms; passive movements were painful. Muscle tone in the arms was low, in the legs — closer to physiological one. Equal and brisk tendon reflexes from the arms and legs. Large fontanel 1.5[1]1.5 cm, not protruded. X-ray examination of the forearm bones showed a change in the structure of the epiphyses of both forearm bones that was common to syphilitic osteochondritis.Conclusion. The article describes the complexity of diagnosis of early congenital syphilis in a child aged 2 months in the absence of a corresponding anamnesis in his mother. The need to rule out syphilitic infection in infants with motor impairments, born from unexamined mothers, has been emphasized.
Highlights
Congenital syphilis is a severe intrauterine infection which, affecting most of the organs and systems of a child, can lead to his disability
The article presents a case of a monosymptomatic clinical picture of early congenital syphilis
At the age of 1 month, the child had hyperemia, isolated edema of the right forearm, and restriction of limb movements. He was examined by a pediatrician who suspected a fracture of the forearm bones
Summary
Однако заподозрить врожденный сифилис у ребенка при отсутствии сведений о ранее перенесенном сифилисе у матери крайне сложно. Описаны сложности диагностики раннего врожденного сифилиса у ребенка в возрасте 2 мес при отсутствии соответствующего анамнеза у матери. ОБОСНОВАНИЕ Врожденный сифилис — тяжелая внутриутробная инфекция, которая поражает большинство органов и систем ребенка и может приводить к его инвалидизации [1]. Ранний врожденный сифилис (РВС) легко диагностировать при наличии у ребенка клинических проявлений со стороны кожи и слизистых оболочек, таких как сифилитическая пузырчатка, папулезная сыпь, сифилитический ринит [4]. Специфический сифилитический ринит, как правило, развивается на 2–6-й нед жизни ребенка и может быть единственным признаком раннего врожденного сифилиса [1]. Что врожденный сифилис может проявляться моносимптомной клинической картиной: только кожные проявления (генерализованная папулезная сыпь, шелушение), изолированное поражение костной системы или внутренних органов [12,13,14].
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