WordNet

a common venereal disease caused by the treponema pallidum spirochete; symptoms change through progressive stages; can be congenital (transmitted through the placenta) (同)syph, pox, lues venerea, lues
present at birth but not necessarily hereditary; acquired during fetal development (同)inborn, innate

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梅毒
(病気・身体的欠陥など)生まれつきの,先天的な

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/07/10 17:14:02」(JST)

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Congenital syphilis is syphilis present in utero and at birth, and occurs when a child is born to a mother with secondary syphilis. Untreated syphilis results in a high risk of a bad outcome of pregnancy, including mulberry molars in the fetus. Syphilis can cause miscarriages, premature births, stillbirths, or death of newborn babies. Some infants with congenital syphilis have symptoms at birth, but most develop symptoms later. Untreated babies can have deformities, delays in development, or seizures along with many other problems such as rash, fever, hepatosplenomegaly, anemia, and jaundice. Sores on infected babies are infectious. Rarely, the symptoms of syphilis go unseen in infants so that they develop the symptoms of late-stage syphilis, including damage to their bones, teeth, eyes, ears, and brain.^[1]

Classification

Early

This is a subset of cases of congenital syphilis. Newborns may be asymptomatic and are only identified on routine prenatal screening. If not identified and treated, these newborns develop poor feeding and rhinorrhea. By definition, early congenital syphilis occurs in children between 0 and 2 years old.^[2] After, they can develop late congenital syphilis.

Symptomatic newborns, if not stillborn, are born premature, with hepatosplenomegaly, skeletal abnormalities, pneumonia and a bullous skin disease known as pemphigus syphiliticus.^[3]

Late

Late congenital syphilis is a subset of cases of congenital syphilis. By definition, it occurs in children at or greater than 2 years of age who acquired the infection trans-placentally.

Symptoms include^[4]

blunted upper incisor teeth known as Hutchinson's teeth
inflammation of the cornea known as interstitial keratitis
deafness from auditory nerve disease
frontal bossing (prominence of the brow ridge)
saddle nose (collapse of the bony part of nose)
hard palate defect
swollen knees
saber shins
short maxillae
protruding mandible

A frequently-found group of symptoms is Hutchinson's triad, which consists of Hutchinson's teeth (notched incisors), keratitis and deafness and occurs in 63% of cases.^[4]

Treatment (with penicillin) before the development of late symptoms is essential.^[5]

Signs and symptoms

abnormal x-rays.
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 inflammation of the cornea which can lead to corneal scarring and potentially blindness.
mulberry molars (sixth year molars with multiple poorly developed cusps).
frontal bossing.
poorly developed maxillae.
enlarged liver.
enlarged spleen.
petechiae.
other skin rash.
sabre shins.
anemia.
lymph node enlargement.
jaundice.
pseudoparalysis.
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.
Higoumenakis sign, enlargement of the sternal end of clavicle in late congenital syphilis.

Death from congenital syphilis is usually through pulmonary hemorrhage.

Treatment

If a pregnant mother is identified as being infected with syphilis, treatment can effectively prevent congenital syphilis from developing in the unborn child, especially if she is treated before the sixteenth week of pregnancy. The child is at greatest risk of contracting syphilis when the mother is in the early stages of infection, but the disease can be passed at any point during pregnancy, even during delivery (if the child had not already contracted it). A woman in the secondary stage of syphilis decreases her child's risk of developing congenital syphilis by 98% if she receives treatment before the last month of pregnancy.^[6] An afflicted child can be treated using antibiotics much like an adult; however, any developmental symptoms are likely to be permanent.

Kassowitz’s law is an empirical observation used in context of congenital syphilis stating that the greater the duration between the infection of the mother and pregnancy, the better is the outcome for the infant. Features of a better outcome include less chance of stillbirth and of developing congenital syphilis.^[7]

References

^ http://www.niaid.nih.gov/factsheets/stdsyph.htm accessed 10/17/2006.
^ http://www.pitt.edu/~SUPER1/lecture/lec13881/008.htm
^ eMedicine - Syphilis : Article by Muhammad Waseem.
^ ^a ^b http://www.pitt.edu/~SUPER1/lecture/lec13881/016.htm
^ Sexually Transmitted Diseases Treatment Guidelines - 2002
^ Congenital syphilis.
^ Singh, Ameeta E.; Barbara Romanowski (1 April 1999). "Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features". Clinical Microbiology Reviews 12 (2): 187–209. PMC 88914. PMID 10194456. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=88914. Retrieved 2008-06-26.

External links

Images of Congenital Syphilis Manifestations
00655 at CHORUS

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 先天梅毒：臨床的特徴および診断 congenital syphilis clinical features and diagnosis
2. 先天梅毒：評価、マネージメント、および予防 congenital syphilis evaluation management and prevention
3. 妊娠中の梅毒 syphilis in pregnancy
4. 腕を動かさない小児の評価 evaluation of the immobile arm in children
5. TORCH感染の概要 overview of torch infections

English Journal

Missed opportunities for preventing congenital syphilis infection.

Introcaso CE, Bradley H, Gruber D, Markowitz LE.SourceDivision of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA. E-mail: vie4@cdc.gov Louisiana Office of Public Health STD/HIV Program, New Orleans, LA Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Sexually transmitted diseases.Sex Transm Dis.2013 May;40(5):431. doi: 10.1097/OLQ.0b013e31828fce51.
PMID 23584807

Risk factors and pregnancy outcomes in women with syphilis diagnosed using a molecular approach.

Casal C, Araújo ED, Corvelo TC.Collaborators (4)Silva A, Farias Y, Spada P, Calado D.
Sexually transmitted infections.Sex Transm Infect.2013 May;89(3):257-261. Epub 2012 Oct 4.
OBJECTIVES: To investigate the risk factors for infection and the outcome of pregnancy in women diagnosed with syphilis using a molecular approach.METHODS: Case-control study of pregnant women admitted to a maternity ward, with the cases classified as early or latent maternal syphilis, based on clin
PMID 23038710

Japanese Journal

症例報告妊娠8か月で救急受診し,先天梅毒による子宮内胎児死亡と診断した1例

齋藤真由子,矢野倫子,浅田佳代 [他]
東京産科婦人科学会会誌 62(4), 642-647, 2013-10
NAID 40019903765

症例報告先天梅毒の一例

上西園幸子,須郷慶信,祐森明日菜 [他]
関東連合産科婦人科学会誌 49(4), 615-620, 2012
NAID 40019781229

梅毒感染妊婦7例の周産期予後に関する検討

水主川純,定月みゆき,中西美紗緒,箕浦茂樹
日本周産期・新生児医学会雑誌 = Journal of Japan Society of Perinatal and Neonatal Medicine 46(4), 1263-1266, 2010-12-20
NAID 10027853857

Related Pictures

★リンクテーブル★

リンク元	「先天性梅毒」
関連記事	「congenita」「congenital」

「先天性梅毒」

Congenital syphilis
	Classification and external resources
	; Notched incisors known as Hutchinson's teeth which are characteristic of congenital syphilis
ICD-10	A50
ICD-9	090
DiseasesDB	12744
eMedicine	ped/2193
MeSH	D013590

　　[★]

英: congenital syphilis
ラ: syphilis congenita
同: 先天梅毒
関: 早発性先天梅毒

[show details]

先天性梅毒 : 約 13,800 件
先天梅毒 : 約 10,900 件

概念

経胎盤的に梅毒トレポネーマが胎児に感染して発症する。

疫学

妊娠13週までは胎児の感染率が低い。

胎盤の発達と関係。妊娠7週から形成が始まり、妊娠4ヶ月末(妊娠15週末,妊娠前期末)に完成。

病型

1. stillbirth, 2.infantile syphilis, 3. late/tardive congenital syphilis (BPT.704)

1. stillbirth

2.infantile syphilis

3. late/tardive congenital syphilis

Hutchinson triad

症状

G10M.179

水頭症、難聴、老人様顔貌、鼻炎、粘膜斑(梅毒性天疱瘡)、黄疸、貧血、点状出血、パロー仮性麻痺、肝脾腫、骨軟骨炎

脛骨の変形

梅毒トレポネーマが骨膜に存在することで形質細胞中心の炎症が起こる　→　脛骨の内側と前方に骨膜への骨の蓄積が起こる(サーベル状脛骨、フルニエ脛骨)

鞍鼻

USMLE

Q book p.289 10

「congenita」

　　[★]

adj.

(後置するラテン語形容詞)先天性の

関: congenital、congenitally

ex.

dyskeratosis congenita、myotonia congenita

「congenital」

　　[★]

adj.

生まれつきの、先天的な

[0] ttp://www.niaid.nih.gov/factsheets/stdsyph.htm accessed 10/17/2006.

[1] ttp://www.pitt.edu/~SUPER1/lecture/lec13881/008.htm

[2] Medicine - Syphilis : Article by Muhammad Waseem.

[pitt-3] ttp://www.pitt.edu/~SUPER1/lecture/lec13881/016.htm

[4] Sexually Transmitted Diseases Treatment Guidelines - 2002

[5] Congenital syphilis.

[6] Singh, Ameeta E.; Barbara Romanowski (1 April 1999). "Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features". Clinical Microbiology Reviews 12 (2): 187–209. PMC 88914. PMID 10194456. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=88914. Retrieved 2008-06-26.

匿名

検索

案内

案内

congenital syphilis