Congenital syphilis presenting with prenatal bowel hyperechogenicity and necrotizing enterocolitis

OpenAlex İngilizce

C ongenital syphilis (CS) is a severe infectious disease that arises from vertical transmission of treponema pallidum via the placenta from untreated pregnant women and may result in mortality of the 40% in the postnatal period.[1,2] Although all the organs are affected by this spirochete, the effects on the fetus range from diffuse organ involvement to nonspecific presenting signs and symptoms.More than 50% of all infected infants are asymptomatic at birth.Clinical manifestations of CS can be classified as follows: gestational (stillbirth, prematurity, and small for gestational age), reticuloendothelial (anemia, white blood cell count abnormalities, and/or thrombocytopenia may result in hepatomegaly with or without spleen involvement), mucocutaneous (rhinitis, dermal rash), skeletal (symmetrical long bone lesions, metaphyseal lesions, osteochondritis, osteitis, dactylitis), neurologic (acute meningitis, hydrocephalus, cerebral infarcts), and ocular (glaucoma, chorioretinitis.[3,4] CS is continuing to be a public health burden in both developed, especially in developing countries and is still a severe cause of infant mortality.Thus, prenatal screening and penicillin treatment are strongly recommended for the prevention of the CS.[5] Congenital syphilis is a severe disease that arises from the vertical transmission of Treponema pallidum.Clinical findings are related to the pregnancy stage, fetal gestational week, maternal treatment and fetal immunologic response.Prematurity, low birth weight, nonimmune hydrops fetalis, necrotizing enterecolitis, hepatomegaly, skin eruptions, thrombocytopenia, hemolytic anemia and fever can be detected in the symptomatic newborn.Postnatal respiratory insufficiency, hepatomegaly, anemia and thrombocytopenia were detected in a baby who was born at the 29 th week of gestation, weighing 1.160 g and followed due to intestinal hyperechogenicity from the second trimester.Her and her mother's Venereal Disease Research Laboratory titers were positive, confirming test Treponema pallidum hemagglutination was reactive.After penicillin was administered for 10 days, anemia, and thrombocytopenia were regressed.In the 15 th day of life, findings of perforated necrotising enterocolitis (NEC) suddenly appeared.The operation was performed due to NEC for three times but nonresponsive laboratory and clinical findings and died in the 54 th day of life.We assumed that syphilis is the cause of both bowel hyperechogenicity and necrotising enterocolitis.