RT Book, Section
A1 Weinberg, Samuel
A1 Prose, Neil S.
A1 Kristal, Leonard
SR Print(0)
ID 6987195
T1 Section 4. Spirochetal, Protozoal, and Mycobacterial Diseases
T2 Color Atlas of Pediatric Dermatology, 4e
YR 2008
FD 2008
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-145543-5
LK accesspediatrics.mhmedical.com/content.aspx?aid=6987195
RD 2023/03/25
AB In  utero  infection  by  the  spirochete  Treponema  pallidum  can  occur  after  the  16th  week  of  gestation.  Intrauterine  disease,  especially  during  early  pregnancy,  may  result  in  spontaneous  abortion  or  in  a  severely  affected  infant.  Severe  disease  that  is  present  at  birth  presents  with  hepatosplenomegaly,  ascites,  meningoencephalitis,  and  severe  anemia.  Osteochondritis  is  the  most  characteristic  bone  change.  The  cutaneous  findings  in  severe  congenital  syphilis  include  bullae,  pustules,  macules,  and  papules.  Fissuring  and  peeling  of  the  skin  are  also  characteristic.  The  palms,  soles,  and  periorificial  skin  are  sites  of  predilection.  Syphilitic  rhinitis,  with  a  copious  and  bloody  nasal  discharge,  is  an  associated  finding.  If  infection  occurs  late  in  pregnancy,  signs  and  symptoms  may  be  delayed  for  several  weeks.  In  these  cases,  diagnosis  is  usually  made  on  the  basis  of  a  positive  syphilis  serology  in  mother  and  infant.  If  the  disease  is  allowed  to  progress,  rhinitis,  cutaneous  macules,  and  mucous  patches  may  be  the  presenting  signs.