All issues > Volume 10(1); 1967

Case Report

J Korean Pediatr Soc. 1967;10(1):43-48. Published online January 31, 1967.

The Clinical Study of Congenital Syphilis in Newborn and Infants

Yong Im Yoon¹, Hyun Sook Lee¹, Young Joo Cho¹, Dong Shik Chin¹

¹Department of Pediatrics, College of Medcine,Ewha Womans University Seoul, Korea

Abstract

The authors observed 24 cases of congenital syphilis in the newborn and infants treated at pediatric ward and O.P'D. in Ewha Womans University Hospital during the period from Jan. 1965 to July, 1966. Clinical manifestations were developed at birth in 14 cases which were born all prematurely, 5 cases, which were full-term babies except for one premature, within 5 days of life and 5 cases, all full-term, were in 1| to 6 months after birth. The most common symptoms were skin eruption (79.1%) with desquomation and dry, mostly involved the palms and soles, anemia (100%) that was persistently aggravated for 3 to 4 weeks in spite of penicillin therapy, and thereafter there was no evidences of more aggravation, but also that of rapid improvement, and abdominal distention with enlargement of liver (79.1%) and spleen(58.3%). Rhinitis, usually known as "snuffles” and most common localized symptom of congenital syphilis, was present in only 6 cases (25%). Jaundice was developed in all cases, but not included in clinical -manifestation of congenital syphilis except for 9 cases (37. 5%) with early onset, high concentration of serum bilirubin and prolonged persistency of jaundice, because of difficulty of differentiation between physiologic jaundice and that of syphilis in early life, particulary in a case of premature. X-ray of long bone was taken in only 9 cases within 2 weeks of life, pathologic findings such as periostitis and osteochondritis were found in legs of 3 cases. V.D.R.L. slide flocculation tests showed all positive reaction in both patients and their parents, that is, + to ++ in 19 cases of the newborn and +++ to +++ in 5 cases of early infant and all parents. It is noticed that only 15 fathers and 3 mothers were answered with agreement to their past history in spite of strong positive revealed in their serologic tests and doctor's consultation about the syphilis, and that only 3 fathers and 2 mothers were received adequate treatment for their own disease. All cases were treated immediately by injection of penicillin, which schedule was in accordance with Nelson’s textbook of pediatrics, if there was clinical evidence of active syphilis which was manifested in every one. One or more blood transfusions were added to therapy in 3 cases developed severe anemia. Of 24 cases, 4 (16. 6%) in the newborn were expired within 72 hrs of life without significant complication, 20 cases survived were improved satisfactorily, but we regret to say that no more futher observation was obtained beyond 2 months following treatment.

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