Congenital syphilis is caused by Treponema pallidum in contact with the fetus of a sick mother affected with syphilis through the placenta.
A healthy placenta is a filter to pale treponem.
- For the penetration of spirochetes in the fetus requires the prior defeat of syphilis placenta to a subsequent breach of the placental barrier. Infection of the fetus through the placenta can occur either when the pale treponema are entered in the child’s body as the emboli through the umbilical vein or when the pale treponema penetrate into the lymphatic system of the fetus through the umbilical cord lymph gap.
Effect of syphilis on pregnancy expressed in violation of its course in the form of late miscarriages and premature births, and often stillbirths (preterm or term), the birth of sick children.
Symptoms of congenital syphilis:
- In view of the clinical manifestations from an epidemiological point of view, distinguish the following periods of congenital syphilis: Syphilis fetus, early congenital syphilis (syphilis, it is isolated infancy and early childhood syphilis) and late congenital syphilis (after 4 years).
- When syphilis gestational specific lesion of the internal organs and systems, which leads to late miscarriages and stillbirths.
The dead fetus has a characteristic appearance:
- Loose skin, macerated due to underdevelopment of subcutaneous fat, is easy to assemble in small folds, his face wrinkled and gets kind of old (old man’s face). Noted an increase in the liver, spleen and white phenomenon pneumonia.
Clinical manifestations of congenital syphilis infants occurs during the first 2 months of life. At the same time affects the skin, mucous membranes and internal organs.
- The earliest eruption in this period is a syphilitic pemphigus. Eruptions are located on the palms, soles, arms and legs. On the basis of infiltrating appear bubbles the size of a pea and a cherry, first serous contents, then it becomes purulent, sometimes hemorrhagic. Bubbles surrounded by a zone specific papular infiltrate bluish-red.
At 8-10 weeks after birth appears diffuse infiltration Gohzingera, which is usually localized on the soles, palms, face and scalp. Then develop the characteristic features of the disease: the defeat sharply delimited, has a first smooth, shiny, bluish-red, and then cracked, brownish-red surface differs tightly-elastic consistency that leads to the formation of cracks, which the circumference of the mouth are the radial direction and leave life so called radiant scars Robinson-Fournier. In addition, there are widespread or limited roseolous, papular and pustular eruptions in all their varieties, similar to those in the secondary period of syphilis. These roseola have a penchant for mergers and peeling. There is a violation of general condition of the child (fever), microfocal or diffuse hair loss, development of syphilitic rhinitis (narrowing of the nasal passages, mucopus, shrinking to peel). Breathing through the nose dramatically difficult, which makes it impossible act of sucking. Papular infiltrate septum se leads to destruction and deformation of the nose (as a saddle or blunt, “goat”). There defeat the skeletal system in the form of osteochondritis, ending with pathological fractures of the extremities (psevdoparalich Parrot).
If congenital syphilis early childhood on the skin are more common (usually oozing) lesions such as warts widely, on mucous membranes – erosive papules; commonly affected bones (syphilitic periostitis of long bones), at least – the internal organs and the nervous system.
Manifestations of late congenital syphilis occur between the ages of 5 to 17 years, but can also appear later. Symptoms of late congenital syphilis can be divided into signs of “unconditional,” probable “and” degenerative “and often correspond to the defeat of various organs and systems in the acquired tertiary syphilis.
It is a sure sign of a triad Hutchinson: problems with teeth (or barrel shape Chisel cutters, hypoplasia of the chewing surfaces of the lunate notch free edge); parenchymal keratitis (uniform milky clouding of the cornea with photophobia, lacrimation and blepharospasm); labyrinthine deafness (inflammation and hemorrhage in the inner ear combined with degenerative processes in the auditory nerve).