Asymptomatic congenital Neuro-syphilis

Research output: Contribution to conferencePaperpeer-review

Abstract

Background: Syphilis affects pregnant women resulting in perinatal morbidity and mortality. It could present as a congenital infections by trans-placental transmission during pregnancy and during labor. The congenital syphilis involved any organs with present in various symptoms included neurological signs. Case Presentation Summary : A five-days-old preterm baby boy (32 weeks), 1.950 g, was born by caesarean section due to premature contraction. Mother is 19 years, Indonesian with first and unwanted pregnancy. Baby was referred to Cipto Mangunkusumo hospital and presented with hydrops-fetalis and respiratory distress. Mother has reactive serologic test for syphilis at third trimester of pregnancy but she did not received adequate treatment. Father has ulcus durum and mother has lesion like condyloma acuminata. On physical examination revealed moderately ill, mild jaundice, with body weight 1.650 grams. Baby has enlargement of liver and spleen. No pallor, no skin rash, no nasal discharge, no edema nor sign of neurologic abnormality. Laboratory findings revealed WBC 40.000/μL, platelet 30.600/μL, I/T ratio 0.17, CRP 10.4 mg/L and abnormal of coagulation factors. The diagnosis at admission was neonatal sepsis. The serum VDRL and TPHA test were reactive with titers 1:16 and 1:1280, respectively. Cerebrospinal fluid (CSF) analysis showed WBC 350 cell/μL (175/μLPMN and 175/μL MN) and proteins 660 mg/dL, accompanied with reactive VDRL and TPHA with titers 1:8 and 1:1280, respectively. The diagnosis of asymptomatic congenital neuro-syphilis was established. The infant was administered with procaine penicillin 50,000 U/kg BW, once daily, intramuscular for 10 days. In the follow up after one-month of therapy titer of serum VDRL and TPHA were 1:64 and 1:1280, respectively. Re-examination we plan at age of three months. The parents were treated per protocol from Dermatovenereology Department. Learning Points/Discussion : Awareness of syphilis detection and management during pregnancy is still low. Strengthening surveillance on sexual transmitted infection is mandatory to reduce congenital disease transmission.
Original languageEnglish
Publication statusPublished - 2017
Event11th International Congress of Tropical Pediatric - ID, Yogyakarta, Indonesia
Duration: 1 Jan 2017 → …

Conference

Conference11th International Congress of Tropical Pediatric
CountryIndonesia
CityYogyakarta
Period1/01/17 → …

Keywords

  • Asymptomatic congenital neuro-syphilis, VDRL and TPHA tests serum and CSF, Procaine penicillin.

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