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    Congenital Syphilis

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    oranut

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    Congenital Syphilis

    Uploaded by

    oranut
    4 views8 pages

    Original Title

    Congenital Syphilis (1)

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    4 views8 pages

    Congenital Syphilis

    Uploaded by

    oranut

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    © All Rights Reserved
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    CONGENITAL

    SYPHILIS
    Congenital syphilis (CS) is caused by transmission of the spirochete
    Treponema pallidum from mother to fetus, resulting in diverse clinical
    presentations.
    Pathophysiology
    In adults, syphilis initiates an infection after local infiltration
    through subcutaneous tissues to cause a local immune
    response and establish an initial ulcerative lesion. However,
    congenital syphilis differs from syphilis in adults in that T.
    pallidum is released straight into the bloodstream of the
    fetus causing spirochetemia with spread to most organs
    including the bones, kidney, spleen, liver, and heart. This
    leads to widespread inflammation throughout these organ
    systems leading to a variety of clinical manifestations.
    Symptoms and Signs
    Early congenital syphilis commonly manifests during the first 3 months of
    life. Manifestations include characteristic vesiculobullous eruptions or a
    macular, copper-colored rash on the palms and soles and papular lesions
    around the nose and mouth and in the diaper area, as well as petechial
    lesions.
    Within the first 8 months of life, osteochondritis (chondroepiphysitis),
    especially of the long bones and ribs, may cause pseudoparalysis of the
    limbs with characteristic radiologic changes in the bones.
    Symptoms and Signs
    Late congenital syphilis typically manifests after 2 years of life and causes
    gummatous ulcers that tend to involve the nose, septum, and hard palate
    and periosteal lesions.Optic atrophy, sometimes leading to blindness, may
    occur. Interstitial keratitis, the most common eye lesion, frequently recurs,
    often resulting in corneal scarring. Sensorineural deafness, which is often
    progressive, may appear at any age. Hutchinson incisors, mulberry molars,
    perioral fissures (rhagades), and maldevelopment of the maxilla resulting
    in “bulldog” facies are characteristic, if infrequent, sequelae.
    Treatment
    In confirmed or highly probable cases, the 2021 Centers for Disease Control and
    Prevention (CDC) STI treatment guidelinesrecommend aqueous crystalline
    penicillin G 50,000 units/kg IV every 12 hours for the first 7 days of life and every
    8 hours thereafter for a total of 10 days or procaine penicillin G 50,000 units/kg
    IM once/day for 10 days ( see Table: Recommended Dosages of Selected
    Parenteral Antibiotics for Neonates). If ≥ 1 day of therapy is missed, the entire
    course must be repeated. This regimen is also recommended for infants with
    possible syphilis if the mother fits any of the following criteria:
    Untreated
    Treatment status unknown
    Treated ≤ 4 weeks before delivery
    Inadequately treated (a nonpenicillin regimen)
    Maternal evidence of relapse or reinfection (≥ 4-fold increase in maternal
    titer)
    Nursing Management
    Educate patient on safe sex practice
    Encourage the use of condoms
    Encourage treatment of a partner
    Administer benzathine penicillin
    Educate the patient on avoiding sex with an infected partner
    Listen to the heart for the murmur of aortic regurgitation
    Check the chest x-ray report (syphilis can cause aortic aneurysms)
    Assess neurologic and mental status (rule out tertiary syphilis)
    Assess genitals to ensure healing has occurred
    Thank You

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