Symptoms, signs and treatment of congenital syphilis. Manifestation of syphilis in children Ways of infection with syphilis in children

Syphilis (lues) is a sexually transmitted disease, usually chronic, of an infectious nature, characterized by systemicity. It is manifested by specific lesions of the skin, all mucous membranes, most bones, various internal organs, and most importantly, the nervous system. It is caused by a dangerous, very active bacterium, which received a sonorous name - pale treponema. Transmitted (most often) sexually, as well as through household items.

Congenital syphilis is especially dangerous in children, when a dangerous infection is transmitted to a child from a sick mother through the placenta. It can be diagnosed at different ages, and therefore there are several types of the disease.

The classification of congenital syphilis detected in children is based on the age at which this disease manifests itself. The range is quite wide: from infancy to adolescence.

For further prediction, the time of manifestation of specific lesions has great importance: the earlier the symptoms are detected, the more favorable it is. Doctors diagnose the following forms of the disease.

early congenital syphilis

Fetal syphilis

Most often, doctors diagnose early congenital syphilis of the fetus when intrauterine infection occurs. If this happened at 5-6 months, they may begin. The baby is usually born dead, macerated (flabby, swollen, loose body), with pathologies of the lungs, spleen, liver.

syphilis of infancy

If the infection of the mother occurred in late pregnancy, the symptoms of the disease appear after the birth of the baby. When diagnosing syphilis in infancy, the Wasserman reaction is detected only at the 3rd month of a newborn's life.

Syphilis in early childhood

This form of the disease is said if it manifested itself between the ages of 1 and 4 years.

late congenital syphilis

In most cases, late congenital syphilis manifests itself and is diagnosed in children in adolescence, until then, without revealing itself in any way. This is a dangerous relapse of the disease, transferred to early childhood- not detected or insufficiently treated in time.

Latent congenital syphilis

This form of the disease can be observed in a child at any age. Its complexity is that it usually proceeds in the absence of symptoms. Therefore, latent congenital syphilis can only be detected as a result of serological studies (carried out on the basis of biological material, most often cerebrospinal fluid).

All these forms of congenital syphilis do not pass without a trace. Among the most dangerous consequences are disability and mortality. The symptomatology of the latent disease allows the child to live to a certain moment, and he will not differ in any way from his peers in his development. However, you need to understand that someday the infection will still manifest itself.

through the pages of history. Syphilis was named in 1530 by an Italian poet and doctor named Girolamo Fracastoro.

Causes of the disease

Pale treponema infects the fetus, penetrating to it into the placenta through the lymphatic slits of the vessels or the umbilical vein. It is transmitted to a child from a mother with syphilis. Children are at risk if:

the infection of the woman occurred before conception;
infection was diagnosed at different stages of pregnancy;
the mother is ill with secondary or congenital syphilis.

The transmission of bacteria from mother to child occurs in the first years of her infection, when the stage of the disease is active. With the passage of age, this ability gradually weakens.

If a woman suffers from a chronic form, but is constantly being treated, she may well have a healthy baby. Therefore, it is necessary to constantly undergo special examinations and carefully monitor the condition of the fetus during its intrauterine development, and then - for its health in the future, in order to detect even a latent form of the disease in time. To do this, you need to know the clinical picture of the course of the infection, i.e., its symptoms.

Keep in mind! The transmission of the infection to the fetus from the sperm has not been scientifically proven, so there is no point in blaming the father of the child for congenital syphilis.

Symptoms

Since there are still chances for a healthy baby to appear if the mother is infected, it is necessary to identify signs of congenital syphilis in time even at the stage of intrauterine development of the fetus. This will allow you to take the necessary measures, find out the degree of infection activity and make at least some forecasts for the future. The symptomatology of the disease is very diverse and largely depends on the stage at which it was detected, that is, on its form.

Symptoms of congenital syphilis of the fetus

Large size of the fetus;
small body weight;
maceration (swelling, friability);
enlarged liver, its atrophy;
enlarged, compacted spleen;
underdeveloped kidneys, covered with a crust;
stomach ulcers;
damage to the central nervous system, brain.

Symptoms of congenital syphilis of infancy

Dry, wrinkled face;
a large head with strongly developed tubercles on the forehead, a pronounced venous network, seborrheic crusts;
pigmentation on the face;
sunken nose bridge;
pale, dirty yellow, flabby skin;
thin, cyanotic limbs;
the child is restless, constantly crying, sleeping poorly, screaming piercingly;
poor development;
weight loss;
persistent runny nose, which causes difficulty in breathing and sucking;
with a complete absence of fatty subcutaneous tissue;
over time, bedsores form;
syphilitic pemphigus on the palms, soles, face, elbows, knees: large vesicles with purulent contents;
epidemic pemphigus - these are large blisters merging with each other, bleeding, eroded, accompanied by high fever, diarrhea, green stools;
diffuse thickening of the skin - scaly erosion on the palms, face, soles, head, accompanied by loss of hair and eyebrows, swelling of the lips, cracks in the corners of the mouth, crusts on the chin, ulcers on the entire surface of the body;
erysipelas;
redness of the heels;
papular syphilide - the formation of copper-red papules and age spots;
roseola rash - individual scaly brownish spots that tend to merge;
syphilitic alopecia - loss of hair, eyelashes, eyebrows;
syphilitic rhinitis - hypertrophy of the mucous membrane of the nose, mouth, larynx;
Wegner's syphilitic osteochondritis is a pathological lesion of the skeletal system, which often leads to a false paralysis-like condition, when the upper limbs hang with whips, the lower ones are constantly bent at the knees;
damage to the joints in congenital syphilis in an infant is expressed by a movement disorder, complete immobility of the limbs;
eye damage is sometimes the only sign of congenital syphilis: the fundus is pigmented, later - loss of vision, keratitis.

Symptoms of congenital syphilis at an early age

The skin of the genitals, groin, anus, interdigital folds on the legs are affected by limited large weeping papules;
roseolous rashes;
seizures in the corners of the mouth;
papules on the mucous membrane of the larynx merge, causing a hoarse, hoarse voice, aphonia, stenosis of the larynx;
syphilitic rhinitis;
baldness;
increase lymph nodes;
periostitis, osteoperiostitis, osteosclerosis - a pathological lesion of the skeletal system;
enlargement, hardening of the spleen and liver;
nephrosonephritis (kidney dystrophy);
enlargement, hardening of the testicles;
as a result of damage to the nervous system, mental retardation is often diagnosed with congenital syphilis, as well as epileptiform seizures, hemiplegia (paralysis of one part of the body),;
eye damage: chorioritinitis, optic nerve atrophy, keratitis.

Symptoms of late congenital syphilis

Reliable signs

Keratitis is a pathological inflammation of the cornea of the eye, which is accompanied by clouding of the mucous membrane in separate areas, photophobia, lacrimation, blepharospasm, decreased visual acuity, atrophy of the optic nerve up to complete blindness;
dental dystrophies;
specific labyrinthitis - deafness, combined with difficulty in speech, dumbness may occur.

Likely signs

Specific drives - damage to the knee joints, which increase, swell, hurt;
bone damage leads to the fact that the symptoms of late congenital syphilis are visible to the naked eye: the shins become saber-shaped, and the child's gait changes greatly;
saddle nose;
buttock-shaped skull;
dystrophy of teeth;
radial scars, which are called Robinson-Fournier, near the mouth, chin;
due to a serious lesion of the central nervous system, oligophrenia is possible with congenital syphilis, as well as a speech disorder;
specific retinitis;
dystrophy (stigma).

The external manifestation of congenital syphilis in a child rarely goes unnoticed, unless it is a latent form of the disease. The damage to internal organs and systems is so powerful and extensive that already in infancy, the symptoms are noticeable even with the naked eye. They are difficult to confuse with signs of other diseases, especially since the infection of the baby is most often talked about during pregnancy.

It is especially important for parents to know how congenital syphilis manifests itself in adolescence (i.e. late), since at the beginning of the child’s life he did not find himself outwardly, while the harmful bacterium destroyed his tissues from the inside. Under laboratory conditions, the diagnosis is refuted or confirmed fairly quickly.

Important information. If the latent form of congenital syphilis is not cured in time, the matured child will be a living carrier of pale treponema, infecting other people with it.

Diagnostics

Since the disease in the mother is detected at any stage of pregnancy, a thorough diagnosis of congenital syphilis in the child is carried out while he is still in the womb. In the future, it represents all kinds of laboratory research.

X-ray. The disease is detected on an X-ray examination, which is performed at 5-6 months of pregnancy. It is recognized by specific osteochondritis (inflammation of the bones) or osteoperiostitis (inflammation of the periosteum).
Serological reactions of Wasserman, Kolmer, Kahn, Sachs-Vitebsky (KSR). They are based on the fact that an antigen is introduced into the child's blood, and then the body's reaction to it is studied.
The reaction of immobilization of bacteria that cause syphilis - pale treponema (RIBT).
Immunofluorescence reactions (RIF).
Study of the cerebrospinal fluid.
X-ray of the osteoarticular apparatus.
Examination of a child by such doctors as a pediatrician, neuropathologist, ophthalmologist, otolaryngologist.

All data based on the studies carried out are entered into the protocol for diagnosing congenital syphilis, according to which the disease is being treated. This medical document accompanies the child throughout his life, the results of tests and reactions are regularly entered into it, which are carried out constantly to monitor the patient's condition.

With proper care and a full course of treatment, which was carried out in a timely manner, the prognosis for a sick child can be quite favorable.

through the pages of history. August Wasserman - German microbiologist and immunologist of the late XIX - early XX century, created an express method for diagnosing syphilis.

Forecasts for the future

The prognosis for the future of a child with congenital syphilis can be very different. From the risk of dying in the womb to full recovery after birth. There are many concerns during and after pregnancy:

late miscarriage;
premature birth;
pathology;
the birth of a dead baby.

It is impossible to predict what will happen in one case or another. A different outcome of pregnancy depends on numerous factors: the stages of the course of the process, the treatment that the mother has undergone or is still undergoing, the degree of intrauterine infection of the fetus, the activity of the infection, and much more.

Given the modern medical technologies that are used to treat congenital syphilis, with proper nutrition, careful care of the baby, breastfeeding, one can hope for positive results and recovery.

The timing of the start of therapy is very important. In infants with this disease, standard serological reactions are restored by the first year of life. With late congenital syphilis, they become negative less often.

Treatment Methods

If the disease was detected in a timely manner, the treatment of congenital syphilis in infants gives positive results. The later the diagnosis was made, as well as with a latent form of infection, the consequences for the health and life of the child can be the most unfavorable, up to death. Treatment includes drug therapy and proper care.

Medical therapy

Vitamin therapy;
injections of penicillin and its derivatives (ecmonovocillin, bicillin);
phenoxypenicillin;
bismuth (if the child is more than six months old);
if the child is allergic to penicillin - erythromycin, tetracycline, cephalosporins;
a combination of muscle injection of antibacterial drugs with endolumbar injection (into the spine) and with pyrotherapy (artificial temperature increase);
arsenic derivatives (miarsenol, novarsenol);
immunomodulators;
biogenic stimulants.

Care

Regular hygiene procedures, since with such a disease, the skin of the child is primarily affected;
breast-feeding;
complete nutrition, which should include foods high in vitamins and proteins;
daily regimen with meals at the same time, night sleep for at least 9 hours, as well as daytime sleep;
daily walks or at least stay in the fresh air;
regular spa specific treatment;
constant monitoring and visits to the appropriate doctors.

If congenital syphilis of any form and stage is detected, the patient is placed in a venereal dispensary for therapy.

If a woman underwent appropriate treatment during pregnancy and the body of the newborn received all the necessary procedures in the 1st month of her life, the disease does not pose a threat to later life child. If the diagnosis was made later, with latent forms and a late stage, therapy may not give results. In this case, the consequences may be the most undesirable.

Dangerous Consequences

The dangerous consequences of congenital syphilis for the further health of infected children will depend entirely on the timely course of treatment and the form of the disease. In most cases, they can still be avoided.

In the absence of specific timely therapy, the child may remain disabled for life or die due to the defeat of too many internal organs, systems and tissues by treponema.

Untreated, advanced congenital syphilis can lead to:

mental and physical retardation;
external deformities in the form of deformation of the skull, limbs, teeth, nose;
dystrophy;
dermatitis;
baldness;
loss of vision;
deafness
dumbness;
paralysis;
impotence in the future in boys and infertility in girls.

All these are symptoms of congenital syphilis, which, if not properly treated, progress and give rise to serious pathologies. As a result, irreversible processes lead to a child's disability for life.

Dangerous consequences, like the disease itself, can be easily avoided if preventive measures are taken in time.

Prevention

If the mother was infected before the 5th month of pregnancy, active and successful prevention of congenital syphilis is possible, since pathological metamorphoses of organs and tissues begin only at the 5th or 6th month. Therefore, fetal treatment early dates pregnancy leads to the birth of a healthy baby. If a woman has also undergone an appropriate course of therapy, the child is not in danger.

The modern level of medicine and early diagnosis of the disease make it possible to detect and treat congenital syphilis in a child in advance. This allows you to avoid dangerous consequences for the life and health of the baby in the future. An infected woman must also undergo a mandatory course of therapy and be under the close and constant supervision of doctors.

This diagnosis is not a sentence, it does not always end in death or disability, contrary to popular belief. Fight for your children - and even this disease will be defeated!

Congenital syphilis in children appears during prenatal infection of the child from an infected mother. The causative agent of the disease - pale treponema penetrates the walls of the placenta. There are different forms of the disease - fetal syphilis, early childhood syphilis, a late form of the disease.

The prevalence of the disease on the territory of the Russian Federation in 2015 is: about 80% congenital syphilis and 5% classic cases of the disease. At the same time, 53% of the disease is transmitted in utero in the Russian Federation. During the epidemic crisis in the Russian Federation, the progression of the disease was 300 cases per 100,000 population of the Russian Federation. Among men, this disease is more common than among women.

The path of transmission of the disease is sexual contact, in utero, through the surfaces of household items (household).

The greatest danger is the congenital form in children, during which the pathogen is transmitted from mother to fetus by penetrating the placenta. Diagnosis of the disease is carried out in different age categories, this is due to the allocation of types of the disease.

Early syphilis in children is divided into the following types:

Intrauterine form of the disease - manifests itself at the stage of intrauterine infection. If this condition occurs at the 5th month of pregnancy, premature labor often begins. The child is often born not alive, his body is swollen, the skin is flabby, pathological lesions of many internal organs are noted.
Illness in infants. If a mother becomes infected with treponema pallidum during the period of bearing a child in the later stages, the main signs are noted already after his birth. When syphilis is diagnosed in infants, tests show it in the blood fluid when the baby is three months old.
Illness in early childhood. This form is diagnosed if it is determined from a year to 4 years of a child.

There are also such concepts as late syphilis of congenital genesis, it manifests itself in the puberty period, until the indicated age there are no symptoms of the disease. At this age, the disease flares up with renewed vigor, while it is judged that in early childhood the disease was not diagnosed or its treatment was not successful enough and in this moment dangerous consequences developed in the child.

The reasons

The causative agent is introduced through the walls of the placenta, while infecting the fetus. Transmission occurs from an infected mother to a child, transmission of the infection from the sperm of a man during sexual contact has not been proven. The risk group consists of such children:

If a woman is infected before the fertilization of the egg;
If the disease is diagnosed at any stage of pregnancy;
If the mother of the child is ill with a secondary or congenital form of the disease.

The pathogen is transmitted to the fetus at the active stage of the disease. In recovered women, this risk is reduced. If a woman has been ill, pregnancy planning is under the supervision of a doctor to prevent a recurrence of the disease, while the blood remains in certain period antibody diagnosis.

If syphilis is diagnosed in a man - the father of a child, a woman should regularly re-test for the presence of pale treponema in the blood.

In the event that a woman has a disease of chronic etiology, but is constantly being treated, there is a chance to give birth to a healthy child. Therefore, a blood test is important, which is constantly given throughout pregnancy. It is important to constantly monitor the condition of the child even in utero, and after the birth of the baby, take an analysis for the presence of the causative agent of the disease.

If the analysis for the presence of the pathogen is positive, it is important to carry out treatment measures in time to prevent the progression of a dangerous infection. To prevent the latent type of the disease and the health consequences, it is important to know the symptoms and the clinical picture. There are no scientifically proven facts of transmission of infection from men to the fetus, so syphilis occurs in a child only from the mother.

Symptoms

Signs and symptoms depend on what stage it is in. The main symptoms look like this:

If the diagnosis is positive, the fetus is large;
Body weight is small;
Looseness of the epidermis is observed on the body;
The manifestation of the disease is an increase in the size of the internal organs of the abdominal cavity;
Underdevelopment of the kidneys is noted;
The surface of the stomach is covered with ulcers;
Diagnosis reveals pathological changes in the cerebral cortex and fibers of the central nervous system.

In infants, other symptoms and signs of the disease:

The face is all wrinkled, the skin is too dry;
The size of the head exceeds the norm, the appearance of tubercles is noted on the frontal part, the venous and vascular network is clearly manifested. The presence of seborrheic crusts is often noted;
The face is covered with age spots;
The region of the bridge of the nose sinks;
The skin becomes pale, cyanotic, sagging;
There is an unnatural cyanosis of the upper and lower extremities, they are too thin;
The newborn cries all the time, is naughty, behaves too restlessly, his sleep and appetite are disturbed;
If the diagnosis is positive, the baby develops poorly and gains weight;
There are signs such as a severe runny nose, shortness of breath, which become an obstacle to sucking, diarrhea appears, food is not processed;
Congenital syphilis makes itself felt by dystrophy, in which there is no subcutaneous fat;
After a while, the baby develops bedsores that do not heal during the treatment, they rot and become infected;
On the body it is manifested by vesicular formations, the contents are purulent;
Bubble formations merge over time, forming one large wound;
Often there is a thickening of the skin in some places, crusts form on the skin;
Diarrhea or dysfunction in food processing - indigestion leads to the fact that the baby is thin;
If the analysis is positive, the child suffers from erysipelas, red spots appear on the heels;
If antibodies are detected and the analysis is positive, symptoms such as hair loss on the head, eyelashes, eyebrows appear;
The disease manifests itself as a pathological lesion of the bone apparatus, which leads to paralysis of the joints;
Often, the pathology is manifested by the only sign - pigmentation of the fundus, which, after the development of the disease, leads to loss of vision, to keratitis.

Symptoms of a late form of congenital disease:

Reliable signs are the inflammatory process on the cornea of the eyes, it is accompanied by turbidity of the mucous membrane, constant lacrimation, and a violation of the quality of vision. After the development of the disease, atrophy of the optic nerve is noted, after progression, vision disappears;
Diarrhea, disturbances in the work of the gastrointestinal tract;
Consequences are often visible, such as dystrophy of the dentition;
There are consequences, like, which is accompanied by dumbness or difficulties in the speech apparatus.

If treatment is not carried out on time, in the future the child will become a carrier of the pathogen dangerous disease to infect the surrounding men and women.

Diagnostics

Since the disease can be determined at any stage during childbearing, a thorough intrauterine screening of the fetus is carried out at all stages of development. The following examinations are carried out:

X-ray, which determines the violation in the development of the articular or bone apparatus;
Introduction of an antigen into the blood fluid and determination of the body's reaction to it;
The response of the body to the manifestations of the causative agent of the disease;
Examination of the contents of the cerebrospinal fluid.

After birth, the child undergoes mandatory examinations by such doctors as a neuropathologist, pediatrician, ophthalmologist, and ENT specialist. If antibodies are found in the body, timely measures are taken for treatment in children. With timely therapy, congenital syphilis has a favorable prognosis, antibodies remain in the blood fluid for a long time.

How to treat

When detected early in the body, measures to treat the disease give positive results. With a late diagnosis, with a latent form (if antibodies are detected), there are dangerous consequences for the health and even the life of the child. Treatment activities include:

Reception of vitamin complexes;
Intramuscular administration of penicillin and antibacterial drugs from the group (if antibodies are noted in the body);
After the baby reaches 6 months, bismuth preparations are introduced;
If there is a negative reaction to the drug penicillin and consequences after administration (diarrhea or rash), antibiotics of another category are prescribed;
Drugs for treatment are administered intramuscularly, by injection through the spinal cord.
Biogenic stimulants are introduced.

Child care during treatment consists in regular hygiene procedures, constant skin care for the baby. It is important to continue breastfeeding, nutrition should be complete, constantly monitor the child's condition, visit doctors on time. The consequences after a relapse should be detected in time.

Congenital syphilis is a type of disease in which an infant becomes infected with treponema during the prenatal period. Pathology has an unpredictable course, so the symptoms of the disorder may occur immediately or several years after birth.

Causes of congenital syphilis

There is one reason that provokes syphilis in newborns. Infection occurs in the presence of treponema in the mother of the child. If syphilis is detected in the early stages and all the necessary medicines are selected, the chances of having a healthy baby increase significantly. Doctors found that microorganisms affect the internal organs of the fetus only at the 6th month of development.

If the baby appeared in a woman who has already had syphilis for the second time, then the risk of infection of the baby increases. Also negatively affects the condition of the woman in labor and the child:

a secondary form of the disorder, provided that the primary infection was not treated with medication;
ambiguous results of serological diagnostics;
incompleteness of the previous course of therapy;
detection of infection at a late stage (one month before delivery).

A newborn baby becomes a peddler, especially when the rash appears.

In the absence of symptoms of the disorder immediately after childbirth, the child will need to be regularly observed by a doctor and undergo preventive treatment.

Congenital syphilis has its own classification, it is divided into early, late and fetal syphilis. Doctors also divide the infection processes depending on the form of the disorder:

Congenital pathology with symptoms in children under 2 years of age.
Congenital latent syphilis in children under 2 years of age. At the same time, the child does not experience discomfort, there are no obvious symptoms, and serological tests do not confirm the disease.
Unspecified form of pathology.

Children with congenital syphilis, which began to appear a few weeks after birth, will be able to avoid serious consequences. Early diagnosis of the disease allows doctors to start treatment in a timely manner and completely eliminate the infection in the body.

Early congenital syphilis

Fetal syphilis refers to the same common diseases as gonorrhea or chlamydia. The intrauterine method of infection is the most dangerous, since the infection affects a fragile body.

Early congenital syphilis is diagnosed when treponema passes through the placenta during the prenatal period. The activity of microorganisms affects the condition of the fetus, so gynecologists during pregnancy several times do an analysis for syphilis. The blood is examined at least 3 times. Infection of a child can occur at any stage of development. Treponema enters the child's body through the umbilical vessels.

Microorganisms affect the internal organs and tissues of the child, which negatively affects its development.

Early syphilis is diagnosed in children who are not yet one year old. The development of infection in an infant proceeds in 2 stages. The first lasts up to 4 months from the moment of birth. The baby has pathological changes in the mucous membrane and skin. In addition to the rash, a malfunction of the internal organs and the nervous system is diagnosed. From 4 months of life, the main symptoms of the disease disappear. Gummas are formed on the bones, there are serious deviations in the work of the central nervous system.

Diagnose early syphilis in the first 2 months after birth. During this period, infants are contagious and may contribute to the spread of infection. Therefore, only sick people are allowed to care for them. The most dangerous thing is when the child has an infection in a latent form, since it does not manifest itself, but the baby's condition worsens.

Early syphilis has specific symptoms, observed:

osteochondritis, inflammation of the cartilage occurs;
infiltration of the skin, fluid accumulates under it;
the appearance of blisters on the surface of the skin;
impaired development of the brain;
inflammation of the periosteum;
meningitis.

Children, unlike healthy peers, will develop more slowly and be naughty regularly. Symptoms of early congenital syphilis will lead to disturbed sleep and poor appetite.

Late congenital syphilis

This form of the disease is different in that its symptoms do not become visible immediately after birth. Late syphilis can occur in a latent form up to 15 years. Children usually learn that they are infected during adolescence. On the skin and mucous membrane of the patient, gums, tubercles and scars will appear, and disturbances in the endocrine system will occur.

Late syphilis appears during puberty due to hormonal changes and reduced immunity. Symptoms of late manifestation of infection are:

Sealing of the liver and disruption of its work.
Pathological changes in the kidneys, up to necrosis.
Severe cough, shortness of breath and other signs of impaired lung function.
Inflammation of the inner lining of the heart.
Damage to the digestive tract, which will provoke diarrhea, nausea, bloating, etc.

Cases when a woman who becomes ill for the first time infects her child during pregnancy or childbirth are exceptions. Much more dangerous for a baby is a secondary or chronic form of infection.

Parents and the child will have to be constantly monitored by dermatovenereologists, otherwise there is a risk of serious complications.

Symptoms and signs

Even if the mother is infected, there is a chance of giving birth to a healthy child, but this requires emergency treatment. Symptoms of congenital syphilis depend on what stage the infection is at and what form it takes.

Early congenital syphilis is classified into infection in a child under 2 years of age and disease in infants. In newborns, signs of the disorder occur in the first 2 months of life. Syphilitic vesicles appear all over the body, and a rash also occurs on the mucous membranes and skin.

Usually in infants there is nasal congestion, purulent discharge from the nostrils. Runny nose is accompanied severe swelling mucosa and difficulty in breathing. Syphilitic nasal congestion is not treated with the usual drops or sprays, so a runny nose will last a long time before parents suspect an infection. Due to swelling, the child will not be able to breathe normally, sniffing will be heard. All symptoms will be pronounced, since treponema enters the baby's body through the placenta and from that moment they begin to develop.

Congenital syphilis in young children quickly affects the condition of the cartilaginous tissue and leads to its deformation. At the 10th week of a baby's life, an infiltrate begins to form in the chin, buttocks and limbs. The baby's lips become thick, so the skin quickly cracks and the wounds bleed. Moisturizing creams and ointments will not help, since cracks occur due to high internal pressure in the tissues. Also, infants are diagnosed with the appearance of ulcerative lesions in the area in the throat area, which makes the voice hoarse. Treponema begins to affect the bone tissue, which leads to osteochondritis.

In children under 2 years old, there is an eye disease, papular rashes, disruption of the nervous system and the occurrence of wide condylomas. Internal organs, as well as bone and cartilaginous tissue, rarely suffer. In the photo in our article, you can see what rashes are observed in children during this period.

Late congenital syphilis is found in adolescence. The infection provokes the appearance of syphilis on the trunk, face and mucous membranes. In a few days they turn into ulcers. In addition to the rash, a characteristic symptom is the Hutchinson triad, that is, a change appearance incisors, keratitis and syphilitic labyrinth.

Diagnosis of the disease in newborns

The diagnostic process is much more complicated, since there is a possibility of transferring maternal IgG antibodies to the child. The diagnosis is based on the detection of the disease in adults and the results of laboratory tests.

For this, a serological examination, ophthalmoscopy, ultrasound, X-ray and vestibulometry, etc. are prescribed. Unfortunately, reliable result it is quite difficult to obtain, so conclusions are made on the basis of the condition of the patient and his immediate family.

Treatment

With timely detection, congenital syphilis is quite easily treated.

Drug therapy is recognized as ineffective in advanced cases of latent syphilis. The infant is prescribed a complex of drugs aimed at improving immunity and suppressing the activity of treponema. It includes:

multivitamins;
injections of drugs with penicillin (the undisputed leaders are bicillin and ekmonovocillin);
biogenic stimulants;
arsenic-derived drugs (novarselon or miarselon);
preparations for artificial temperature increase;
erythromycin or cephalosporin in the presence of an allergic reaction.

Parents will need to carefully care for their child during treatment. It is necessary to carry out hygiene procedures regularly so that the rash does not continue to spread. Diet adjustment will be required, doctors recommend food that contains a lot of proteins and useful microelements.

If congenital syphilis is detected, the child is placed in a hospital. This is necessary because the infant needs to be monitored by medical professionals. A reaction to medications or a complication of the disease can be fatal, so doctors should be nearby during therapy.

Effects

The prognosis depends on the prescribed therapy and how timely assistance was provided. If you refuse to take medication, the child may remain disabled or mentally retarded. The most negative result is death, it occurs with extensive damage to the internal organs by treponema.

Complicated congenital syphilis leads to deafness, complete loss of vision, partial or complete baldness, deformation of the limbs, skull, nose and teeth. Adult men and women can develop infertility due to untreated childhood syphilis.

FROM negative consequences experienced when parents try home treatments and refuse traditional medicines despite vivid symptoms.

Even a complicated form of congenital syphilis can be completely cured in childhood. This will take time and several courses of antibiotics, but the goal is quite achievable.

Prevention

All preventive measures are aimed at preventing the development of a sexually transmitted disease in pregnant women. Expectant mothers must be tested for syphilis during pregnancy. If an infection is detected at an early stage (up to 6 months of pregnancy), a course of treatment is carried out and drugs are given as a prophylaxis. Such measures allow women to get rid of the disease during gestation and give birth to a healthy child.

Parents who have previously had syphilis should also be under the supervision of a doctor and regularly take tests.

Fetal syphilis

This pathology develops in the prenatal period, it is diagnosed before the 5th month of the baby's development. Treponemas affect the compaction and increase in the size of internal organs. The accumulation of infiltrate leads to the development of pneumonia and other pathologies of the lungs.

A pathognomonic sign of fetal syphilis is the detection of signs of osteochondrosis during an X-ray examination. Pathology leads to premature birth, miscarriage, stillbirth, or serious impairment in mental development.

The knowledge of doctors, modern medicines and preventive measures to prevent the disease can completely eliminate the infection and protect the child from the serious consequences of its development.

29.06.2017

Syphilis is a sexually transmitted infection that is transmitted during intimacy. The disease used to be called lues.

The causative agent of an infectious disease are bacteria called treponema pallidum. When entering the body, pathogenic microorganisms affect the skin, mucous membranes, vital organs, nervous and skeletal systems.

Syphilis can be contracted through vaginal, oral or anal sex. It is not uncommon for patients to become infected through a kiss. This happens when an infected person has sores on the lips, on the mucous membrane of the oral cavity.

A child can become infected with syphilis in utero or during the birth process. The causative agents of syphilis easily cross the placental barrier. This can provoke severe gestation of the fetus and the development of serious abnormalities in it.

What happens in the child's body when infected

If during pregnancy the expectant mother suffered a secondary stage of syphilis, then the child may develop early congenital syphilis. Its manifestations can be seen already in the second month of a baby's life.

Congenital syphilis contributes to the defeat of the central nervous system, vital organs, mucous membranes and cause significant changes in the skin.

Congenital syphilis occurs in conjunction with pseudoparalysis, that is, soft tumors are formed in the long tubular bone.

When the nervous system is affected, meningitis develops, accompanied by convulsive syndromes; eye pupils have a different size and shape; paralysis.

The development of syphilitic meningitis occurs gradually, the temperature gradually rises. In the first ten days of life, the baby is hyperexcitable and has occasional seizures.

A frequent complication of congenital syphilis is a violation of the normal development of the brain. Hydrocephalus develops due to hypersecretion of cerebrospinal fluid and narrowing of the CSF space.

This is due to syphilitic lesions of the membrane and epithelial membrane of the cardiac ventricles.

Three months after birth infection may be accompanied by distal peripheral paralysis of the upper extremities.

Up to four years, the child has neurological disorders that cause specific endarteritis. vascular obliteration and cerebral ischemia.

There are frequent cases of central hemiparesis with a focal or secondary generalized convulsive attack.

The vascular form of syphilis may be accompanied by isolated reflex immobility of the pupils and different sizes, sensation of the upper eyelid, strabismus and atrophy of the optic nerve.

The clinical course delays the intellectual development of the baby.

After four years, congenital syphilis develops into inflammation of the cornea, labyrinthine deafness, saddle nose deformity, and tooth dystrophy.

Paralysis begins to progress from the age of twelve and neurological symptoms slowly increase, namely the lag in mental and mental development, behavioral disorders.

If appropriate treatment is not started in time, then pregnancy can end in miscarriage, premature birth, and the development of intrauterine pathologies. It is possible that the baby will still be born or die a few months after birth.

Syphilis and kindergarten

No matter how hard parents try and protect their child, there are diseases that cannot be avoided. Especially, it concerns "collective" diseases.

Most of the diseases, the child picks up in kindergarten, as children use common subjects personal hygiene, such as toilet, bedding, dishes and so on. A child with an infection can easily pass it on to another kindergarten student.

It's a shame that nowadays medical workers it is easier to pay money to the inspection commission than to carefully monitor the order and cleanliness in the kindergarten.

This is not a reason not to take your child to kindergarten, you just need to take care of an additional measure of security.

If a parent with syphilis who is undergoing appropriate treatment sends the child to Kindergarten ik, then they must necessarily warn the management of the preschool institution about this.

Parents must provide a certificate stating that the child is healthy and they are undergoing treatment.

If during the passage of the medical commission, one of the employees was diagnosed with an infectious disease, then the doctors must check the rest of the employees and all children. At the same time, the sick caregiver is suspended from work.

Until the doctors check all the children, the kindergarten is closed for quarantine.

Symptoms of an infectious disease in children

Syphilis develops in several stages and its symptoms depend on it. In medical practice, very often there are situations when a pregnant woman is unaware of the development of an infection in her body, and passes it on to her unborn child.

When a woman is planning a child, she should carefully monitor her body. She should be alerted by the appearance of ulcers on the skin or mucous membranes.

Ulcers begin to appear a month after infection. A woman may not notice the formation of ulcers in the mouth or in the vagina. If you do not start treatment, then the symptoms may disappear, but at this time, syphilis pathogens continue to multiply and spread throughout the body, thanks to the circulatory system.

The first symptoms of syphilis are an increase in lymph nodes, the appearance of skin rashes on the palms and feet.

During pregnancy, such symptoms can occur in any month. Because of this, the risk of intrauterine infection increases.

After the baby is born, it is examined by specialists. If there are skin rashes, damage to the skin on the genitals and around the anus, nasal discharge, enlarged lymph nodes, pneumonia and anemia, then these are the first symptoms of syphilis in children.

How does syphilis manifest itself in children? Syphilis in children, as in adults, can occur without obvious symptoms, but after two or three months, signs of syphilis in children will definitely appear.

After a few years, syphilis can manifest itself as a neurological disease, bone and tooth deformity. The child may become deaf or blind. Therefore, it is very important to diagnose the disease at an early stage of development.

Diagnosis of syphilis in childhood

It is necessary to diagnose syphilis based on the characteristic skin rashes and the internal state of the child's body. First of all, the doctor conducts an epidemiological history, which indicates the presence of patients with syphilis in the family. And of course, laboratory tests are carried out.

Laboratory diagnosis is carried out using bacterioscopic and serological studies.

In order to optimally influence the children's body, doctors perform dark-field and phase-contrast microscopy.

Histological preparations are prepared, which are impregnated with silver. For research, the detachable part of the chancre, punctate of the lymph node and scraping of roseola, etc. are taken.

Serological reaction is the main method of laboratory research of the syphilis pathogen. In addition to diagnosis, it is used to evaluate the effectiveness of treatment and to observe the healing process.

There are two types of serological reaction:

Nonspecific is carried out without the participation of pale treponema. Diagnosis is carried out by the Wasserman reaction (express diagnosis of syphilis) and a laboratory study of a sexually transmitted disease. To do this, take a biological material and place it on a glass slide, adding cardiolipin-lecithin-cholesterol Ar to it. A positive reaction can be in the middle of the primary and during the secondary stage, in the third stage, the result can be negative.
Specific. Treponema pallidum immobilization reaction and immunofluorescence reaction are carried out. The results can be positive in most cases of primary seronegative period.

Treatment of syphilis in children

If the baby was born without any signs of syphilis, but the mother is infected, then treatment is still carried out. These kids are being watched for a long time.

Doctors regularly take samples for serological testing. In such cases, syphilis in children is treated as indicated.

Previously, salvarsan and mercury were used to treat syphilis in childhood. Novarsenol for newborns was prescribed 20 mg per 1 kg of total weight. For children aged two to four years - 10 mg per 1 kg of total weight, and 15 mg for older children.

A dosage for newborns of 10 mg per kg of weight will be considered appropriate, and if the newborn is weakened, then 5 mg at all. Novarsenol is administered intravenously, you need to dilute it in hot sterile saline.

Miarsenol has a positive effect, which is administered in the same way as Novarsenol. The dosage is the same.

In medicine, the drug Sovarsen is used, with a dosage of 2.5 mg for children under one year old, 5 mg for children under three years old and 10-20 mg from three years old.

Doctors can prescribe osarsol with a dosage of 3 mg for infants, after a year - 6 mg, after two years 15 mg. medicinal product taken three times a day.

First, the child is injected with Novarsenol or Miarsenol by injection, after 30 minutes an injection is made with bioquinol or mercury. The dosage has been halved. This method of therapy is carried out once every 6 days.

If the baby was diagnosed with late syphilis, then doctors prescribe 5% potassium iodide 10 mg three times a day. The course of treatment is carried out in periods. the child must go through at least six such periods.

If doctors prescribe large doses, then the treatment lasts three months. During this time, the child should receive calomel and neosalvar injections, each with 12 pieces.

If, with a repeated Wasserman reaction, the results are positive, then the child undergoes an additional course of treatment.

To date, for the treatment of a newborn diagnosed with syphilis, penicillin is a great success. The injection is carried out every five hours. Treatment begins with a minimum dosage and gradually increase it.

The course of treatment lasts two weeks, then there is a break and a second course is carried out. In general, there should be three such courses. After that, the child receives combined treatment.

Prevention of infectious disease

There is no specific immunoprophylaxis, so it is worth paying attention to non-specific preventive measures.

For the prevention of acquired syphilis, regular preventive examinations of people who work in medical and children's institutions and food enterprises are used.

In schools and institutes, teachers should carry out health education and teach teenagers the basic rules of personal hygiene and sexual literacy and organize individual prevention.

In order to prevent congenital syphilis, a woman during the gestation period should be on a dispensary examination in a antenatal clinic. A pregnant woman undergoes a double serological control in the first and third trimester.

When a woman diagnosed with syphilis gives birth to a child, doctors monitor the child for the first year of life. The next observation is carried out at the age of 16 years.

If syphilis is acquired and diagnosed at an early stage, then doctors put a favorable prognosis, but congenital syphilis has a less favorable outcome.

Parents who themselves have suffered from a syphilitic infection often ask themselves the question: “Do children get syphilis?”. Unfortunately, the answer is: yes, they do.

The body of a child is also vulnerable to pale treponema, like the body of an adult. The situation is also complicated by the fact that pale treponema (the causative agent of syphilis) is transmitted not only sexually, but also by household. The greatest risk of catching an infection for a child exists precisely in a family where one of the relatives has syphilis.

We tell why and how children get syphilis and what are the consequences of the disease for the child's body.

How common is syphilis in children
Syphilis at school or kindergarten
Treatment of syphilis in children
Consequences of syphilis in children

How can you infect a child with syphilis?

If there are people suffering from syphilis in the permanent environment of the child (family, kindergarten, school, hobby), then the risk of infection definitely exists. The likelihood of getting infected will depend on several conditions. First of all - from possible ways of infection.

A child can “get” syphilis in several ways.

The most common route of infection is household

Pale treponema can enter the child's body if the child comes into contact with someone suffering from active primary or secondary syphilis (when the patient's skin has various types of syphilitic rash).

Contacts of the child with the patient can be of the following types:

Through a rash in primary and secondary syphilis
On contact with the saliva of an infected person
Through breast milk

Domestic ways of infection for a child: through a patient's rash, through contact with infected saliva, through breast milk

Infection by "artificial" way

In addition to domestic infection, it is possible and artificial(artificial) way of transmission of pale treponema. This type of infection includes various penetrations into the body with the help of tools.

The main artificial ways of infection:

during blood transfusion
through injections in the hospital
at the dentist
in a beauty salon (contact with non-sterile needles or scissors)
during acupuncture
for any other penetrating interventions in the body - if non-sterile instruments are used

Infection by artificial means is quite rare and the reason is always the same - unscrupulously processed inventory. Most often, it is not medical institutions that are to blame (although this is possible), but various private organizations - cosmetic and dental offices, alternative medicine salons, tattoo parlors, and so on. It is simply impossible to foresee such a risk and avoid it 100%. It remains only to be vigilant and choose institutions with a proven track record.

How common is syphilis in children?

Acquired syphilis in children is almost 10 times less common than in adults. Syphilis in early childhood occurs primarily due to close household contact with infected relatives.

That is why, when syphilis is found in an adult, all family members must be examined and preventive treatment. This prevents the possible development of syphilis in children and other households.

Syphilis in adolescents and children school age occurs more frequently.

In addition to family contacts, the main causes of infection here are:

early onset of sexual activity
ignorance of safety measures in the sexual sphere or neglect of them
close household contact between children (sharing bottles, cigarettes, toys, passing candy or chewing gum from mouth to mouth)

All this significantly increases the proportion of children infected with syphilis among the Russian population.

Syphilis at school or kindergarten.

Examination for syphilis among teachers, educators and other employees of children's institutions is carried out 2 times a year. On average, in Moscow and St. Petersburg, from 5 to 20 cases of syphilis are detected per year in employees of educational institutions. In other cities - less, but so far only because of a smaller population.

If a caregiver or teacher is diagnosed with syphilis

If it turns out that an employee of a children's institution is sick with syphilis, he must be suspended from work for the duration of treatment.

Work with syphilis in kindergarten, as in others educational institutions, it is forbidden

If a person, working with children, deliberately hides that he has syphilis, then he can be brought to administrative or criminal liability. Such an employee will be suspended from work and prosecuted.

Children who have been in contact with an infected worker must be tested for syphilis, and parents must be informed of the incident.

If it turns out that a child has syphilis

In a situation where a child has positive tests for syphilis, he is suspended from school or taken away from kindergarten and treated in a dermatovenerological dispensary (or at home under the supervision of a dermatovenereologist). That is, children with syphilis do not study in any separate schools - they are simply temporarily taken home or to the hospital.

The parents of this child are also examined and treated: if the tests for syphilis are negative, then the treatment will be preventive, and if positive, then it will be complete.

After a full course of treatment, the child can return to their school or kindergarten. Children cured of syphilis are not dangerous to other children and attend the same kindergartens and schools as children who have never had syphilis.

How does acquired syphilis develop in a child?

Acquired syphilis in children has the same symptoms and develops in the same way as in adults. The disease has the same periods - incubation, primary, secondary and tertiary.

It is important to remember that the signs of syphilis in girls and boys do not differ, the infection flows the same way in both sexes.

Consider briefly all the stages and their features.

Incubation period in children

When pale treponema enters the body through damaged mucous or skin, nothing happens in the first 3-4 weeks. The child feels the same as usual. There are no visible signs of the disease either, so it is, unfortunately, impossible to suspect it.

Primary syphilis in children

After 3-4 weeks, it's time for the primary stage of the disease: at the site of the introduction of treponema, a hard chancre (a small, dense and painless ulcer) is formed - the first sign of syphilis in both children and adults.

In addition to hard chancre, primary syphilis can be suspected by inflammation of the lymph nodes and lymphatic vessels (lymphangitis and lymphadenitis). They become inflamed closest to the place of introduction of treponema. Inflammation looks like an increase in size, swelling of the lymph nodes and sometimes - a small "wire" seal from the chancre along the lymphatic vessel.

In children with syphilis, hard chancre is most often found on the lips or in the oral cavity - on the tongue, the back of the throat; less often - outside the mouth.

Primary syphilis lasts about six to seven weeks. You can read more about how the primary period of syphilis proceeds in a special material.

Secondary syphilis in children

Approximately 1.5 months after the appearance of a hard chancre, a rash appears on the child's body - a sign of secondary syphilis. The rash is often accompanied by fever, which can last from 1 to 5 days.

In the photo, secondary syphilis in children can resemble classic childhood infections - measles, chickenpox, rubella, and so on. However, unlike them, a syphilitic rash on the body lasts from 2-3 weeks to several months.

Rash in children with syphilis may be:

roseolous (from spots of 2-3 mm)
papular (from nodules from 1 mm to 1 cm)
or less often - pustular (from pustules)

Secondary syphilis lasts 3-4 years and proceeds in waves: periods of rashes are several times replaced by periods of deceptive well-being - when no signs of syphilis are observed in a child.

Syphilis in children is similar to rubella or chickenpox: in the photo you can see how similar these manifestations are.

If such syphilis is not treated, then in 3-4 years it will turn into tertiary.

Tertiary syphilis in children

Tertiary syphilis is the most serious and destructive stage of the disease. At this stage, gummas (bumps) and bumps form under the skin and inside the child's body.

These formations remain on the skin or inside the body for a long time (sometimes for several years). Then purulent processes begin in them. And when the ulcer breaks through, it destroys the surrounding tissue.

The breakthrough of an ulcer has a very bad effect on the area where it arose: not only areas of the skin can be destroyed, but also muscle, cartilage, vascular and bone tissues, and the substance of the brain. If the gumma arose in the internal organ, then it may also suffer.

Read more about how syphilis of internal organs develops in adults in the article "Visceral syphilis".

Treatment of syphilis in children

Acquired syphilis in children is treated in the same way as in adults. A child with syphilis receives the same drugs, approximately according to the same treatment regimen:

preventive (prophylactic) treatment - in one injection of an antibiotic;
treatment of primary syphilis - is carried out for about 10-14 days;
treatment of secondary syphilis, depending on the course, is about 15-20 days;
treatment of tertiary syphilis is carried out in two courses of 14-28 days with a break between them of 14 days.

The number of antibiotic injections can be from 1 time per week to several times a day. It depends on which drug is used and at what stage of syphilis treatment began. The doctor selects drugs strictly individually for each patient.

If the mother infected the child with syphilis during pregnancy, then the treatment will differ from the standard courses. Then it is carried out special scheme for congenital syphilis. Read more about this in the article "Congenital syphilis".

Consequences of syphilis in children

The consequences of syphilis in children directly depend on when treatment began.

If the treatment was carried out in the primary or secondary period of syphilis, then in most cases the consequences of the disease can be avoided.

If syphilis has passed into the tertiary stage, then there is a high risk of irreversible changes in the skin, in the skeletal system and in the internal organs. Without treatment, tertiary syphilis can last for years and eventually lead to disability and death.

The consequences of late syphilis in a child may be:

syphilis of the nervous system - various forms lead to disability and dementia;
syphilis of the cardiovascular system - damage to the aorta, aortic valve, coronary vessels; leads to heart failure and coronary heart disease;
syphilis of the skeletal system - destruction and deformation of bones, destruction of cartilaginous tissue, formation of a saddle nose, fistula of the hard palate, and so on;
syphilis of internal organs - destructive changes in the liver, kidneys, stomach, lungs and other organs.

Acquired syphilis is very dangerous for the child's body. Infection can occur if there is someone with syphilis in the child's social circle. The most likely route of infection for children is through household contact or breast milk.

Children's syphilis is treated in much the same way as an adult, but with smaller doses of drugs. The sooner treatment begins, the greater the chance of avoiding the severe consequences of the infection.

To prevent childhood syphilis, school and kindergarten workers are tested for this infection twice a year.

If one of the adults fell ill with syphilis, children and other members of his family must be tested and undergo preventive treatment.

Types of congenital syphilis
Causes of the disease
Symptoms
Diagnostics
Forecasts for the future
Treatment Methods
Dangerous Consequences
Prevention

Types of congenital syphilis

The classification of congenital syphilis detected in children is based on the age at which this disease manifests itself. The range is quite wide: from infancy to adolescence.

For further prognosis, the time of manifestation of specific lesions is of great importance: the earlier the symptoms are detected, the more favorable it is. Doctors diagnose the following forms of the disease.

early congenital syphilis

Fetal syphilis

Most often, doctors diagnose early congenital syphilis of the fetus when intrauterine infection occurs. If this happened at 5-6 months, premature birth may begin. The baby is usually born dead, macerated (flabby, swollen, loose body), with pathologies of the lungs, spleen, liver.

syphilis of infancy

Syphilis in early childhood

This form of the disease is said if it manifested itself between the ages of 1 and 4 years.

late congenital syphilis

In most cases, late congenital syphilis manifests itself and is diagnosed in children in adolescence, without revealing itself before. This is a dangerous recurrence of a disease suffered in early childhood - not detected or insufficiently treated in time.

Latent congenital syphilis

All these forms of congenital syphilis do not pass without a trace. Among the most dangerous consequences are disability and mortality. The symptomatology of a latent disease allows the child to live up to a certain point, and he will not differ in any way from his peers in his development. However, you need to understand that someday the infection will still manifest itself.

through the pages of history. Syphilis was named in 1530 by an Italian poet and doctor named Girolamo Fracastoro.

Causes of the disease

the infection of the woman occurred before conception;
infection was diagnosed at different stages of pregnancy;
the mother is ill with secondary or congenital syphilis.

The transmission of bacteria from mother to child occurs in the first years of her infection, when the stage of the disease is active. With the passage of age, this ability gradually weakens.

Keep in mind! The transmission of the infection to the fetus from the sperm has not been scientifically proven, so there is no point in blaming the father of the child for congenital syphilis.

Symptoms

Symptoms of congenital syphilis of the fetus

Large size of the fetus;
small body weight;
maceration (swelling, friability);
enlarged liver, its atrophy;
enlarged, compacted spleen;
underdeveloped kidneys, covered with a crust;
stomach ulcers;
damage to the central nervous system, brain.

Symptoms of congenital syphilis of infancy

Dry, wrinkled face;
a large head with strongly developed tubercles on the forehead, a pronounced venous network, seborrheic crusts;
pigmentation on the face;
sunken nose bridge;
pale, dirty yellow, flabby skin;
thin, cyanotic limbs;
the child is restless, constantly crying, sleeping poorly, screaming piercingly;
poor development;
weight loss;
persistent runny nose, which causes difficulty in breathing and sucking;
dystrophy with a complete absence of fatty subcutaneous tissue;
over time, bedsores form;
syphilitic pemphigus on the palms, soles, face, elbows, knees: large vesicles with purulent contents;
epidemic pemphigus - these are large blisters merging with each other, bleeding, eroded, accompanied by high fever, diarrhea, green stools;
diffuse thickening of the skin - scaly erosion on the palms, face, soles, head, accompanied by loss of hair and eyebrows, swelling of the lips, cracks in the corners of the mouth, crusts on the chin, ulcers on the entire surface of the body;
erysipelas;
redness of the heels;
papular syphilide - the formation of copper-red papules and age spots;
roseola rash - individual scaly brownish spots that tend to merge;
syphilitic alopecia - loss of hair, eyelashes, eyebrows;
syphilitic rhinitis - hypertrophy of the mucous membrane of the nose, mouth, larynx;
Wegner's syphilitic osteochondritis is a pathological lesion of the skeletal system, which often leads to a false paralysis-like condition, when the upper limbs hang with whips, the lower ones are constantly bent at the knees;
damage to the joints in congenital syphilis in an infant is expressed by a movement disorder, complete immobility of the limbs;
eye damage is sometimes the only sign of congenital syphilis: the fundus is pigmented, later - loss of vision, keratitis.

Symptoms of congenital syphilis at an early age

The skin of the genitals, groin, anus, interdigital folds on the legs are affected by limited large weeping papules;
roseolous rashes;
seizures in the corners of the mouth;
papules on the mucous membrane of the larynx merge, causing a hoarse, hoarse voice, aphonia, stenosis of the larynx;
syphilitic rhinitis;
baldness;
swollen lymph nodes;
periostitis, osteoperiostitis, osteosclerosis - a pathological lesion of the skeletal system;
enlargement, hardening of the spleen and liver;
nephrosonephritis (kidney dystrophy);
enlargement, hardening of the testicles;
as a result of damage to the nervous system, mental retardation is often diagnosed with congenital syphilis, as well as epileptiform seizures, hydrocephalus, hemiplegia (paralysis of one part of the body), meningitis;
eye damage: chorioritinitis, optic nerve atrophy, keratitis.

Symptoms of late congenital syphilis

Reliable signs

Keratitis is a pathological inflammation of the cornea of the eye, which is accompanied by clouding of the mucous membrane in separate areas, photophobia, lacrimation, blepharospasm, decreased visual acuity, atrophy of the optic nerve up to complete blindness;
dental dystrophies;
specific labyrinthitis - deafness, combined with difficulty in speech, dumbness may occur.

Likely signs

Specific drives - damage to the knee joints, which increase, swell, hurt;
bone damage leads to the fact that the symptoms of late congenital syphilis are visible to the naked eye: the shins become saber-shaped, and the child's gait changes greatly;
saddle nose;
buttock-shaped skull;
dystrophy of teeth;
radial scars, which are called Robinson-Fournier, near the mouth, chin;
due to severe damage to the central nervous system, oligophrenia is possible with congenital syphilis, as well as epilepsy and speech disorder;
specific retinitis;
dystrophy (stigma).

Important information. If the latent form of congenital syphilis is not cured in time, the matured child will be a living carrier of pale treponema, infecting other people with it.

Diagnostics

X-ray. The disease is detected on an X-ray examination, which is performed at 5-6 months of pregnancy. It is recognized by specific osteochondritis (inflammation of the bones) or osteoperiostitis (inflammation of the periosteum).
Serological reactions of Wasserman, Kolmer, Kahn, Sachs-Vitebsky (KSR). They are based on the fact that an antigen is introduced into the child's blood, and then the body's reaction to it is studied.
The reaction of immobilization of bacteria that cause syphilis - pale treponema (RIBT).
Immunofluorescence reactions (RIF).
Study of the cerebrospinal fluid.
X-ray of the osteoarticular apparatus.
Examination of a child by such doctors as a pediatrician, neuropathologist, ophthalmologist, otolaryngologist.

With proper care and a full course of treatment, which was carried out in a timely manner, the prognosis for a sick child can be quite favorable.

through the pages of history. August Wasserman - German microbiologist and immunologist of the late XIX - early XX century, created an express method for diagnosing syphilis.

Forecasts for the future

late miscarriage;
premature birth;
pathology;
the birth of a dead baby.

Given the modern medical technologies that are used to treat congenital syphilis, with proper nutrition, careful care of the baby, breastfeeding, one can hope for positive results and recovery.

Treatment Methods

Medical therapy

Vitamin therapy;
injections of penicillin and its derivatives (ecmonovocillin, bicillin);
phenoxypenicillin;
bismuth (if the child is more than six months old);
if the child is allergic to penicillin - erythromycin, tetracycline, cephalosporins;
a combination of muscle injection of antibacterial drugs with endolumbar injection (into the spine) and with pyrotherapy (artificial temperature increase);
arsenic derivatives (miarsenol, novarsenol);
immunomodulators;
biogenic stimulants.

Care

Regular hygiene procedures, since with such a disease, the skin of the child is primarily affected;
breast-feeding;
complete nutrition, which should include foods high in vitamins and proteins;
daily regimen with meals at the same time, night sleep for at least 9 hours, as well as daytime sleep;
daily walks or at least stay in the fresh air;
regular spa specific treatment;
constant monitoring and visits to the appropriate doctors.

If congenital syphilis of any form and stage is detected, the patient is placed in a venereal dispensary for therapy.

If a woman underwent appropriate treatment during pregnancy and the body of the newborn received all the necessary procedures in the first month of her life, the disease does not pose a threat to the future life of the child. If the diagnosis was made later, with latent forms and a late stage, therapy may not give results. In this case, the consequences may be the most undesirable.

Dangerous Consequences

In the absence of specific timely therapy, the child may remain disabled for life or die due to the defeat of too many internal organs, systems and tissues by treponema.

Untreated, advanced congenital syphilis can lead to:

mental and physical retardation;
external deformities in the form of deformation of the skull, limbs, teeth, nose;
dystrophy;
dermatitis;
baldness;
loss of vision;
deafness
dumbness;
paralysis;
impotence in the future in boys and infertility in girls.

Dangerous consequences, like the disease itself, can be easily avoided if preventive measures are taken in time.

Prevention

If the mother was infected before the 5th month of pregnancy, active and successful prevention of congenital syphilis is possible, since pathological metamorphoses of organs and tissues begin only at the 5th or 6th month. Therefore, treatment of the fetus in early pregnancy leads to the birth of a healthy baby. If a woman has also undergone an appropriate course of therapy, the child is not in danger.

This diagnosis is not a sentence, it does not always end in death or disability, contrary to popular belief. Fight for your children - and even this disease will be defeated!

Syphilis is an infectious disease caused by pale treponema, with a predominantly contact mechanism of transmission of the pathogen, a chronic relapsing course and a characteristic periodicity of clinical symptoms that can affect all organs and systems.

From this article, you will learn the main causes and symptoms of syphilis in children, how syphilis is treated in children, and what preventive measures you can take to protect your child from this disease.

Treatment of syphilis in children

Treatment of syphilis in children begins immediately after confirmation of the diagnosis and is carried out in specialized institutions. The number and duration of therapy courses, single and course doses of drugs, the duration of dispensary observation are regulated in the instructional documents.

Treatments for syphilis in children

The drugs of choice for treatment at all stages of syphilis are penicillins (water-soluble or durant).

With intolerance to penicillins, erythromycin, cephalosporins, tetracycline are used to treat syphilis.

In tertiary syphilis, in addition to antibiotics, bismuth compounds (biyoquinol, bismoverol) are used.

Prevention of syphilis in children

Means of specific immunoprophylaxis are absent, so non-specific preventive measures are of primary importance.

Prevention of acquired syphilis: early active detection and treatment of patients with syphilis (if necessary, mandatory, in accordance with the legislation on contact tracing), regular preventive examinations of decreed population groups (medical workers, employees of children's institutions, food enterprises, etc.), screening for syphilis of all inpatients . Sanitary education, teaching adolescents the basics of sexual literacy and the rules of personal hygiene, the organization of individual prevention centers, etc., are of great importance.

Prevention of congenital syphilis: dispensary examination of pregnant women in the antenatal clinic with double serological control in the first and second halves of pregnancy. Newborns from mothers who have had syphilis are subjected to a thorough comprehensive examination in the first months of life (at 2.5-3 months) and at 1 year; subsequent dispensary observation is carried out until the age of 15.

The prognosis for early detection and adequate treatment of acquired syphilis is favorable. With congenital syphilis, the prognosis is less favorable.

Causes of syphilis in children

The causative agent of syphilis

The causative agent of syphilis Treponema pallidum (subspecies pallidum) was discovered in 1905 by F. Shaudin and E. Hoffman. Pale treponema is a thin mobile spiral microorganism, 0.25 microns wide and 5-20 microns long, has 8-12 uniform curls, can exist in 3 forms - spiral, cystic and L-form. The most frequent (classical) course of syphilis is due to the presence of a spiral form of the pathogen, the remaining forms probably support a long latent course. The causative agent of syphilis is unstable in the external environment and dies when dried; heating at a temperature of 40 ° C for an hour leads to the loss of pathogenic properties; at 48°C, bacteria die within 10 min, but in the cold they persist for up to 50 days. Pale treponema quickly dies under the action of antiseptics. Protein, polysaccharide and lipid Ag have been isolated from the causative agent of syphilis.

source of syphilis

The disease is registered everywhere. By the middle of the XX century. the incidence has declined significantly, but since the late 80s. note an increase in the number of cases, and in some regions (including Russia) the incidence reaches almost epidemic levels; in 2000 it was 157.3 cases per 100,000 population. In children, the incidence of syphilis is 8.1-9.2 cases per 100,000 children. The reservoir of the pathogen is a sick person. The main route of transmission is sexual, but in children the contact route of infection is also of great importance (when using household items, toys, medical instruments contaminated with secretions of the patient, etc.). The greatest danger is posed by untreated patients with skin manifestations of primary or secondary syphilis. It is possible to transmit the pathogen from the pregnant woman to the fetus transplacentally or when passing through the birth canal. The pathogen is not able to cross the placenta in the first 4 months of pregnancy; treatment of the mother at these times prevents infection of the fetus.

Syphilis infection

The pathogen enters the human body through microtrauma of the mucous membranes (genital tract, mouth, rectum) or skin, migrates to the lymph nodes, then into the bloodstream and disseminates. Initially, the body's resistance to the pathogen is low (at this time it quickly disseminates through the tissues), then it increases and limits further spread, but does not ensure complete elimination of the pathogen. Such an equilibrium state is unstable - in some patients it is disturbed with the transition to tertiary syphilis. In the late stages of syphilis, hypersensitivity to pale treponema develops, leading to the formation of gummy ulcers and necrosis. Already in the early stages of the disease, the central nervous system is affected. In the absence of adequate treatment in the secondary period of syphilis, a third of patients find changes in the cerebrospinal fluid. During the first 5-10 years after infection, mainly the vessels and membranes of the brain suffer (meningovascular neurosyphilis); later, the parenchyma of the brain and spinal cord. Involvement in the pathological process of the cortex and membranes of the brain leads to progressive paralysis. Damage to the posterior columns of the spinal cord causes dorsal tabes.

Classification of syphilis in children

Table. Classification of syphilis

Acquired syphilis in children

In untreated patients, acquired syphilis lasts for many years, almost a lifetime (self-healing from syphilis, although possible, is unlikely). In the classical course of the disease, four periods are distinguished: incubation, primary, secondary, tertiary. They also allow the possibility of a long-term (long-term) asymptomatic course of acquired syphilis from the very beginning of the disease with the development of later nervous and visceral forms of the disease.

incubation period for syphilis

The incubation period lasts an average of 3-4 weeks. With massive infection, its duration is reduced to 10-15 days, and with severe concomitant diseases and the use of antibiotics in doses insufficient for the preventive treatment of the disease, it increases to 3-5 months.

Primary period of syphilis

The primary period of syphilis lasts from the moment a hard chancre appears to the onset of generalized rashes (6-7 weeks) and is characterized by the development of a hard chancre at the site of introduction of pale treponemas (more often in the genital area) ( ulcus durum) and regional lymphadenitis. Hard chancre, as a rule, is single, small in size (on average 4-5 mm), regular rounded or oval outlines, sloping (saucer-shaped) edges, smooth red bottom with poor discharge, dense elastic (cartilaginous) infiltrate at the base. Regional lymphadenopathy develops a week after the appearance of a hard chancre. Without treatment, the hard chancre resolves in 6-12 weeks, leaving behind a small and pigmentless scar. The localization of a hard chancre clearly indicates the route of infection with syphilis. Distinguish sexual, perisexual and extragenital (extragenital) chancres. In children, a hard chancre is often located on the face, lips, oral mucosa (cheeks, tongue, tonsils), sometimes in the esophagus and stomach. In some children, the chancre is absent or disappears quickly.

Primary syphilis is characterized by increasing sensitization of the body to the pathogen. By the 6-7th week of illness, specific AT appear in the body (transition of primary seronegative syphilis to primary seropositive).

Secondary period of syphilis

The secondary period of syphilis usually develops 6-12 weeks after infection and lasts 3-4 years. From the regional lymph nodes, pale treponema quickly penetrates into the bloodstream, causing a generalized infection - syphilitic septicemia. All organs and systems can be affected, but the main manifestations are rashes on the skin and mucous membranes (secondary syphilides).

The first generalized rash, which usually occurs against the background of a regressing hard chancre, is the most intense (fresh secondary syphilis) and is accompanied by severe polyadenitis. The rash persists for several weeks (less often 2-3 months), then spontaneously disappears for an indefinite time. Repeated episodes of rashes (secondary recurrent syphilis) alternate with periods of complete absence of manifestations (secondary latent syphilis). Syphilides contain a large number of pale treponemas, the latter, when ulcerated, easily enter the external environment, which makes this period of syphilis extremely contagious.

The main types of syphilides of the secondary period are as follows:

Syphilitic roseola: a pink spot measuring 0.51 cm, having irregular rounded outlines, does not peel off, disappears when pressed.

Syphilitic papule: a nodule of bluish-red color of a dense consistency with peeling along the periphery. Varieties of syphilitic papules:

lenticular, 0.3-0.5 cm in size;
miliary, the size of a poppy seed;
inummular (coin-shaped), the size of a large coin, with a tendency to group;
seborrheic, localized on the face, forehead skin and is distinguished by oily scales on the surface;
erosive (weeping), characterized by an erosive or weeping surface, localized on the mucous membrane or in the folds of the skin;
wide condylomas (vegetative papules), located in places of skin friction (groin), differ large sizes, vegetation, erosive surface;
horny papules of the palms and soles, characterized by a powerful development of the stratum corneum on the surface, very reminiscent of corns;
psoriasiform papules, with pronounced peeling on the surface.

Syphilitic pustules usually occur in debilitated patients with a severe (malignant) course of the process.

Syphilitic baldness is a rapidly developing small-focal or diffuse hair loss on the head without inflammatory changes in the skin.

Syphilitic leukoderma (pigmented syphilide) is localized on the lateral and posterior surfaces of the neck, often on the skin of the trunk; hypopigmented round spots 0.5-1 cm in size appear on the affected areas against the background of hyperpigmentation.

Very often the mucous membranes of the oral cavity and genital organs are affected. Eruptions on the mucous membranes are represented by roseola (round spots, often gray-white with a red rim) and papules, rarely pustules.

In addition to rashes on the skin and mucous membranes, secondary syphilis can be accompanied by damage to internal organs (syphilitic hepatitis, nephronephritis, myocarditis, etc.), central nervous system, bones (diffuse periostitis with painful swelling, nighttime pain in the bones; less often osteoperiostitis), joints (polyarthritic synovitis with the formation of effusion in the joint cavity), etc.

Tertiary period of syphilis

The tertiary period of syphilis ("humous") develops 3-6 years after infection in a small number of patients (who have not received adequate treatment or are weakened, in particular with chronic diseases such as tuberculosis, malaria, etc.). The manifestations of tertiary syphilis are most severe and can lead to irreversible disfigurement of the appearance, disability and death. Syphilides of the Tertiary period are represented by 2 elements - tubercles and nodes (gum), differing in size and depth.

The tertiary period of syphilis is characterized by the appearance of limited foci of inflammation in many organs, followed by their destruction and partial or complete loss of function. Any organs can be involved in the pathological process, but most often the skin and mucous membranes, bones, cardiovascular and nervous system. The disease is manifested by chronic interstitial inflammation with outcome in sclerosis (syphilitic hepatitis, cirrhosis, syphilitic mesaortitis with the formation of heart disease, neurosyphilis: meningitis, dorsal tabes, progressive paralysis, etc.) or the formation of syphilis, causing destruction and compression of vital organs (gummas liver, kidneys, skin, brain, intestines, lungs, gummous osteomyelitis, osteoperiostitis). Tertiary syphilis, as well as secondary, is characterized by an alternation of overt and latent clinical manifestations of infection, while patients are practically not contagious, since single treponemas in the depth of the infiltrate die during its decay.

Congenital syphilis in children

Congenital syphilis develops during intrauterine infection of the fetus after the development of placental circulation (20 weeks of gestation). More often, infection occurs in the active period of syphilis in the last 3 months of pregnancy. Pregnancy in women with untreated syphilis may result in late miscarriage, stillbirth, or the birth of a child with active or latent syphilitic infection. The clinical manifestations of congenital syphilis are varied, some of them reflect the current infectious process, others represent violations of embryogenesis due to the teratogenic effects of pale treponema.

Fetal syphilis

Fetal syphilis is accompanied by changes in the internal organs, and somewhat later in the skeletal system. Specific lesions of the internal organs of the fetus are manifested by intercellular infiltration and proliferation of connective tissue. Widespread and severe lesions of the internal organs of the fetus often lead to late miscarriages and stillbirths. Sometimes a child is born alive, but in a serious condition and soon dies.

Early congenital syphilis in children

Early congenital syphilis can first appear both in infancy (up to 12 months) and early childhood (1-4 years). It is an active syphilitic infection similar to the secondary period of acquired syphilis. A hard chancre is not formed in this case, since pale treponema through the umbilical vein immediately enter the internal organs. The debut of the disease is possible both immediately after birth and during the first 2-3 months of life in the form of nonspecific symptoms of a generalized infection (fever, irritability, insufficient weight gain, anemia), polylymphadenopathy and "classic" local lesions. The skin, mucous membranes, bone and nervous systems, parenchymal organs (liver, spleen, lungs) most often suffer, less often the gastrointestinal tract. The main clinical manifestations of early congenital syphilis are presented in Table 294. Patients are contagious and need active treatment.

Table. The main clinical manifestations of early congenital syphilis

Skin and mucous membranes

Syphilitic pemphigus of newborns (symmetrically located blisters on the soles and palms)

Syphilitic rhinitis with deformation of the bone and cartilage tissue of the nose ("saddle" nose)

Diffuse thickening of the skin around the mouth and anus with an outcome in the radial scars of Robinson-Fournier

Spotty and papular rashes on the trunk, limbs, genitals

Common vesicular, bullous, weeping elements

Wide warts in the anus

Skeletal system

Osteochondritis with pathological fractures

Periostitis, osteoperiostitis of long tubular and flat bones

Dactylites

Parrot's false palsy (severe bone pain causing the child to lie still)

CNS, organ of vision

Meningitis, meningoencephalitis with outcome in chorioretinitis, optic nerve atrophy

hydrocephalus

A diagnostically important symptom of early congenital syphilis in boys older than a year is the presence of dense, painful testicles. Early congenital syphilis may present as a monosyndrome (eg, pemphigus syphilis, isolated eye disease, or osteochondritis). The characteristic and lifelong signs of early congenital syphilis include Robinson-Fournier scars around the mouth, saddle nose, and skull deformity.

Late congenital syphilis in children

Currently, due to the widespread use of penicillin, late congenital syphilis is rarely observed. Many authors consider this form of the disease as a relapse of early congenital syphilis or a long-term latent infection. The disease usually manifests itself 4-5 years after the birth of a child (sometimes at 14-15 years). The clinical manifestations of late congenital syphilis resemble those of the tertiary period of acquired syphilis. Reliable signs of late congenital syphilis include the so-called Hutchinson triad, which includes diffuse interstitial keratitis, deafness due to syphilitic labyrinthitis, and barrel-shaped upper incisors with a notch along the free edge (Hutchinson's teeth).

The probable signs of late congenital syphilis include "saber" shins, "Gothic" palate, thickening of the sternal end of the clavicle, various anomalies of the teeth (diastema, macro or microdentia, canine hypoplasia, etc.). However, these symptoms are observed in other diseases.

Diagnosis of syphilis in children

Diagnosis of syphilis is based on the data of the clinical picture (characteristic skin and visceral manifestations), epidemiological history (the presence of a patient with syphilis in the family) and laboratory tests. For laboratory diagnosis of syphilis, mainly bacterioscopic and serological studies are used.

The most optimal microscopic methods for detecting treponemas are dark-field and phase-contrast microscopy. It is also possible to prepare histological preparations impregnated with silver. The material for the study is the detachable chancre, punctates of the lymph nodes, scrapings of roseola, etc.

Serological reactions are the main methods of laboratory diagnosis of syphilis, in addition, they are used to evaluate the effectiveness of treatment and monitor recovery. Serological studies for syphilis are divided into non-specific and specific.

Non-specific tests (without the participation of treponems). The main methods are RSK (Wasserman reaction) and VDRL reaction (from the English Venereal Disease Research Laboratory, laboratory for the study of sexually transmitted diseases) - a specialized flocculation test on slides using cardio-lipin-lecithin-cholesterol Ag. The reactions are positive, starting from the middle of the primary and during the secondary periods, in the tertiary period they can be negative in 50% of patients.

Of the specific tests, the immobilization reaction of pale treponema, RIF (becomes positive in most patients with syphilis already in the primary seronegative period; positive in all periods of syphilis, including late forms, in almost all patients) and ELISA.

Differential diagnosis of syphilis in children

Primary syphilis must be differentiated from genital herpes, soft chancre, venereal lymphogranuloma, erosive balanitis, inguinal granuloma, tuberculosis. For a hard chancre (uncomplicated), unlike other outwardly similar ulcerative lesions, soreness and acute inflammation are not characteristic.

Secondary syphilis is differentiated from drug dermatitis, rosacea, rubella, erythema multiforme, pityriasis versicolor, and fungal infections. Secondary syphilides have a number common features that distinguish them from other skin rashes: they are ubiquitous, have a benign course, there are no febrile symptoms, there are also no acute inflammatory phenomena and subjective sensations, resistance to local treatment is noted, and rapid disappearance under the influence of specific therapy.

Congenital syphilis must be differentiated from other IUIs.

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