Khalid Hussain, Khalid Mahmood Ranjha.
Women and Infants innocent victims of syphilis.
J Coll Physicians Surg Pak Jan ;9(1):53-4.

Syphilis is not an uncommon disease untreated patients transmit the disease to their spouses. Women may transmit the disease to infants. Early detection of syphilis in infants is almost impossible because of the hidden nature of early manifestation of congenital syphilis.

CASE REPORT: A 25-year-old pregnant lady presented with a non-itchy skin rash. Examination revealed erythematous scaly papules on the trunk and limbs in a symmetrical distribution. Pigmented papules and macules were present on palms and soles. Superficial erosions were seen in the mouth. Epitrochlear, axillary and cervical lymph nodes were palpable bilaterally. They were discrete, movable firm and non-tender. Clinically this patient`s lesions were almost pathagnomonic of secondary syphilis. A reactive VDRL (Titre 1:32) and a reactive TPHA confirmed the diagnosis. Her husband was treated for secondary syphilis in the past. He was promiscuous having several extramarital contacts with prostitutes. The lady was pregnant for last 8 months. She was treated with penicillin. She gave birth to a male baby, who was weak, underweight and had wrinkled skin. He had no skin lesions Reactive VDRL (1:64) and TPHA, and X-ray findings in tibiae and fibulae of both sides (featurs of osteochondritis) confirmed that the baby had active congenital (Prenatal) syphilis. The baby was treated with penicillin.

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