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Congenital syphilis physical examination

Introduction

Overview

Overview

Congenital syphilis examination findings include characteristic skin rash, hepatosplenomegaly and interstitial keratitis.

Physical Examination

Physical Examination

General Appearance

Skin

  • Vesiculobullous or maculopapular rash occurring on the palms and soles is present in 70% of the children with congenital syphilis. Other patterns of rash such as condylomata lata lesions, annular lesions, and erythema multiforme -like targetoid lesions are present in affected infants.[2]
  • Later rash – copper-colored, flat or bumpy rash on the face, palms, and soles
  • Frontal bossing
  • Poorly developed maxillae

Eyes

Ears

Nose

  • Snuffles, the name given to rhinitis in this situation. When chronic, this can lead to saddle nose deformity.
  • Rhagades, linear scars at the angles of the mouth and nose result from bacterial infection of skin lesions

Throat

Shown below is an image of Hutchinson’s teeth

By CDC/Susan Lindsley – http://phil.cdc.gov/phil_images/20021114/34/PHIL_2385_lores.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=2134349
  • Hutchinson’s Triad, a set of symptoms consisting of deafness, hutchinson’s teeth (centrally notched, widely-spaced peg-shaped upper central incisors), and interstitial keratitis (IK), an inflamation of the cornea which can lead to corneal scarring and potentially blindness
  • Mulberry molars (sixth year molars with multiple poorly developed cusps)

Abdomen

Extremities

References

References

  1. ↑ Barron SD, Pass RF (1995). “Infectious causes of hydrops fetalis”. Semin Perinatol. 19 (6): 493–501. PMID 8822333.
  2. ↑ Ferreira, Sara Tavares; Correia, Cátia; Marçal, Monica; Tuna, Madalena Lopo (2016). “Skin rash: a manifestation of early congenital syphilis”. BMJ Case Reports: bcr2016216148. doi:10.1136/bcr-2016-216148. ISSN 1757-790X.
  3. ↑ Ewing, C I; Roberts, C; Davidson, D C; Arya, O P (1985). “Early congenital syphilis still occurs”. Archives of Disease in Childhood. 60 (12): 1128–1133. doi:10.1136/adc.60.12.1128. ISSN 0003-9888.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]Aravind Kuchkuntla, M.B.B.S[3]