Clinical analysis of 15 cases of congenital syphilis in neonates

GUO Ming; ZHANG Xuefeng

PDF(1003 KB)

Medical Journal of the Chinese People Armed Police Forces ›› 2023, Vol. 34 ›› Issue (5) : 402-406.

ORIGINAL ARTICLES

Clinical analysis of 15 cases of congenital syphilis in neonates

GUO Ming, ZHANG Xuefeng

Author information +

History +

Abstract

Objective To analyze the perinatal situation, clinical characteristics and treatment outcome of neonates with congenital syphilis.Methods The clinical data of 15 neonates with congenital syphilis admitted to the Department of Pediatrics of the Fifth Medical Center of Chinese PLA General Hospital from March 2012 to May 2022 were retrospectively analyzed.Results Among 15 neonates with congenital syphilis, the gestational age ranged from 32 to 36 weeks in 9 cases (60.0%) and over 37 weeks in 6 cases (40.0%), and eight cases (53.3%) had a birth weight less than 2500 grams. Among the mothers of the neonates with congenital syphilis, 10 people (66.7%) were unemployed, 11 persons (73.3%) had a middle school education, and 11 mothers (73.3%) did not have prenatal examination and treatment. Among the neonates, skin lesions occurred in 6 cases (40.0%), alanine aminotransferase increased in 6 cases (40.0%), direct bilirubin increase occurred in 5 cases (33.3%), nine cases (60.0%) had different degrees of anemia, 5 cases (33.3%) had thrombocytopenia., nephrotic syndrome occurred in 3 cases (20.0%). Pneumonia was diagnosed in 4 cases (26.7%), leukocyte increased in 6 cases (40.0%), C-reactive protein increased in 13 cases (83.7%), convulsions occurred in 1 case (6.7%), and 3 cases (20%) had abnormal long bone radiography.Conclusions The main cause of mother-to-child transmission of syphilis is the irregular prenatal examination and treatment of syphilis mothers, so it is necessary to strengthen the propaganda during pregnancy and syphilis serological testing. The clinical features of neonatal congenital syphilis are complex and diverse without obvious specificity, so suspected children should receive serological examination of syphilis as soon as possible, and timely diagnosis and standardized treatment will get good outcome.

Key words

neonatal syphilis / congenital syphilis / clinical features / syphilis of pregnancy / serological index of syphilis

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

GUO Ming, ZHANG Xuefeng. Clinical analysis of 15 cases of congenital syphilis in neonates[J]. Medical Journal of the Chinese People Armed Police Forces. 2023, 34(5): 402-406

References

[1] 中国疾病预防控制中心性病控制中心,中华医学会皮肤性病学会性病学组,中国医师协会皮肤医师协会性病亚专业委员会. 梅毒、淋病和生殖道沙眼衣原体感染诊疗指南(2020年) [J].中华皮肤科杂志, 2020,53(3):168-179.
[2] Rac M W, Revell P A, Eppes C S. Syphilis during pregnancy: a preventable threat to maternal-fetal health[J]. Am J Obstet Gynecol, 2017, 216(4): 352-363.
[3] Janier M, Hegyi V, Dupin N, et al. 2014 European guideline on the management of syphilis [J].J Eur Acad Dermatol Venereol, 2014, 28(12):1581-1593.
[4] Kimberlin D W, Brady M T, Jackson M A, et al. Red Book: 2015 Report of the Committee on Infectious Diseases. American Academy of Pediatrics. Syphilis[M].30th edition. Elk Grove, Village, IL: American Academy of Pediatrics, 2015: 755.
[5] 冯明智,李姗姗,李晶晶, 等. 1例伴系统性损伤的早期先天性梅毒患儿的临床诊疗与分析[J].抗感染药学, 2021, 18(1): 150-152.
[6] 邵肖梅,叶鸿瑁,丘小汕, 等. 实用新生儿学[M].5版. 北京: 人民卫生出版社, 2019: 536-537.
[7] 姚爱媛,朱东波,吕颖. 妊娠合并梅毒致母婴传播的高风险因素分析[J].中国艾滋病性病, 2020, 26(12): 1352-1354.
[8] 郭辉,庄洁伟,缪文强, 等. 深圳市宝安区梅毒血清固定孕妇的筛查及规范性治疗对妊娠结局和新生儿影响[J].中国性科学, 2020,29(1):125-128.
[9] 金铭晶,陆莹,杜青青. 宁波市2028－2021年新生儿先天性梅毒的流行病学特征调查分析[J].中国地方病防治, 2021,36(3):248-249.
[10] 覃清华,谢小花,姚慧, 等. 2014－2018年广西壮族自治区妊娠合并梅毒感染孕产妇发生不良妊娠结局状况及相关因素分析[J]. 中华预防医学杂志, 2019, 53 (12): 1284-1289.
[11] 石佳立,刘亚兰. 北京市东城区2014－2019年艾滋、梅毒、乙肝母婴传播情况分析[J].中国妇幼健康研究, 2021, 31(9):1185-1186.
[12] 中华人民共和国卫生健康委员会. 预防艾滋病梅毒和乙肝母婴传播工作规范(2020年版)[J] .信息速递, 2021, 28(2): 10-11.
[13] 连宏宇,徐君球,方蓓欢, 等. 2018年－2020年舟山市梅毒母婴阻断相关因素分析[J].中国性科学, 2022, 31(1): 138-141.
[14] 秦琴,宁花兰,张艳珍, 等. 不同治疗时机对妊娠期梅毒妊娠结局的影响及其危险因素分析[J].中国性科学,2018, 27( 5) :96-99.
[15] 高洁,邹颖,吴颖岚, 等. 2013－2016年湖南省预防母婴传播工作效果分析[J].中国艾滋病性病,2018, 24(6): 619-621.
[16] Liu Y,Zhu Y,Wang Y B, et al. Differences between congenital-syphilis presenting as sepsis and neonatal sepsis: a case-control study[J]. Medicine(Baltimore), 2019, 98(44): e17744.
[17] Galvis A E, Arrieta A. Congenital syphilis: A U.S. Perspective[J].Children, 2020,7(11):203.
[18] 张丽芬,钟娜,陈琴, 等. 1152例梅毒孕妇及所产新生儿的梅毒血清学试验结果分析 [J].中国艾滋病性病,2019, 25 (9 ):89-91.
[19] 李典,张华. 52例新生儿先天性梅毒的临床特征调查及血清学指标检测分析[J].中国性科学, 2019, 28 (12): 109-113.
[20] 叶茹意, 茅双根. 先天性梅毒的早期诊断及治疗[J].中华全科医学,2018,16(8):1231-1232.
[21] 徐雅婷,冯明智,吴敏智. 误诊为尿布皮炎的早期先天梅毒一例[J].中国麻风皮肤病杂志,2022,38(4):247-248.
[22] 胡向文,唐文燕,高菊梅. 新生儿先天性梅毒1例[J].南昌大学学报,2019,59(6):90-95.
[23] 陈亚玲, 胡志亮, 陈伟, 等. 59例早期胎传梅毒的临床特征分析[J].临床与病理杂志,2018,38(9):1909-1911.
[24] 吴银弟,温晓红. 先天性梅毒对新生儿早期危害性的临床分析[J].安徽医学,2018,39(6):734-736.
[25] 朱晶文,张雪峰. 先天性梅毒致新生儿多器官功能损害3例临床特征分析[J].中国皮肤性病学杂志,2022,36(6): 690-694.
[26] Garcia L N, Soljan A D, Moroni S, et al. Congenital syphilis in Argentina: experience in a pediatric hospital[J]. PLOS Negl Trop Dis,2021, 15(1): e0009010.
[27] 周湘萍,刘双全. 梅毒感染患者多系统的临床表现[J].中南医学科学杂志,2020,48(2):117-121.
[28] 许云波,陈文超,石年. 新生儿先天性神经梅毒的临床调查分析[J].中国性科学, 2018, 27(1):117-119.
[29] 张海金,刘辉,王志峰. 早发型先天性骨梅毒的X线表现[J].医学影像学杂志, 2017, 27(6):1198-1199.