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Appendices

The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.

Section 3. Summaries of Infectious Diseases

Syphilis

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS:

Congenital Syphilis. Intrauterine infection can result in stillbirth, hydrops fetalis, or prematurity. Infants may have hepatosplenomegaly, snuffles, lymphadenopathy, mucocutaneous lesions, osteochondritis and pseudoparalysis, edema, rash, hemolytic anemia, or thrombocytopenia at birth or within the first months of life. Untreated infants, regardless of whether they have manifestations in early infancy, may develop late manifestations, which usually appear after 2 years of age and involve the central nervous system (CNS), bones and joints, teeth, eyes, and skin. Some consequences of intrauterine infection may not become apparent until many years after birth, such as interstitial keratitis (5–20 years of age), eighth cranial nerve deafness (10–40 years of age), Hutchinson teeth (peg-shaped, notched central incisors), anterior bowing of the shins, frontal bossing, mulberry molars, saddle nose, rhagades, and Clutton joints (symmetric, painless swelling of the knees). The first 3 manifestations are referred to as the Hutchinson triad.

Acquired Syphilis. Infection can be divided into 3 stages. The primary stage appears as one or more painless indurated ulcers (chancres) of the skin or mucous membranes at the site of inoculation. These lesions most commonly appear on the genitalia. The secondary stage, beginning 1 to 2 months later, is characterized by rash, mucocutaneous lesions, and lymphadenopathy. The polymorphic maculopapular rash is generalized and typically includes the palms and soles. In moist areas around the vulva or anus, hypertrophic papular lesions (condylomata lata) can occur. Generalized lymphadenopathy, fever, malaise, splenomegaly, sore throat, headache, and arthralgia can be present. A variable latent period follows but sometimes is interrupted during the first few years by recurrences of symptoms of secondary syphilis. Latent syphilis is defined as the period after infection when patients are . . . [Go to Full Text]


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This topic has been referenced by these articles:

  • Nolt, D., Saad, R., Kouatli, A., Moritz, M. L., Menon, R. K., Michaels, M. G. (2002). Survival With Hypopituitarism From Congenital Syphilis. Pediatrics 109: e63-63 [Abstract] [Full Version]  
  • Saiman, L., Aronson, J., Zhou, J., Gomez-Duarte, C., Gabriel, P. S., Alonso, M., Maloney, S., Schulte, J. (2001). Prevalence of Infectious Diseases Among Internationally Adopted Children. Pediatrics 108: 608-612 [Abstract] [Full Version]  
  • Gust, D. A., Levine, W. C., St. Louis, M. E., Braxton, J., Berman, S. M. (2002). Mortality Associated With Congenital Syphilis in the United States, 1992-1998. Pediatrics 109: e79-79 [Abstract] [Full Version]  
  • Raju, T. N.K. (2006). Hot Brains: Manipulating Body Heat to Save the Brain. Pediatrics 117: e320-e321 [Full Version]  
  • Miller, L. C., Hendrie, N. W. (2000). Health of Children Adopted From China. Pediatrics 105: 76e-76 [Abstract] [Full Version]  
  • Bateman, D. A., Chiriboga, C. A. (2000). Dose-Response Effect of Cocaine on Newborn Head Circumference. Pediatrics 106: 33e-33 [Abstract] [Full Version]  
  • Aggarwal, M., Rein, J. (2003). Acute Human Immunodeficiency Virus Syndrome in an Adolescent. Pediatrics 112: e323-323 [Abstract] [Full Version]