Med Bull Sisli Etfal Hosp. 2020; 54(1): 113-116 | DOI: 10.14744/SEMB.2018.22605

Congenital Syphilis Presenting with Prenatal Bowel Hyperechogenicity and Necrotizing

Muhittin Celik, Ali Bulbul, Sinan Uslu
Department of Pediatrics, Division of Neonatology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey

Congenital syphilis is a severe disease that arises from the vertical transmission of Treponema pallidum. Clinical findings are related to the pregnancy stage, fetal gestational week, maternal treatment and fetal immunologic response. Prematurity, low birth weight, nonimmune hydrops fetalis, necrotizing enterecolitis, hepatomegaly, skin eruptions, thrombocytopenia, hemolytic anemia and fever can be detected in the symptomatic newborn. Postnatal respiratory insufficiency, hepatomegaly, anemia and thrombocytopenia were detected in a baby who was born at the 29th week of gestation, weighing 1.160 g and followed due to intestinal hyperechogenicity from the second trimester. Her and her mother’s Venereal Disease Research Laboratory titers were positive, confirming test Treponema pallidum hemagglutination was reactive. After penicillin was administered for 10 days, anemia, and thrombocytopenia were regressed. In the 15th day of life, findings of perforated necrotising enterocolitis (NEC) suddenly appeared. The operation was performed due to NEC for three times but nonresponsive laboratory and clinical findings and died in the 54th day of life. We assumed that syphilis is the cause of both bowel hyperechogenicity and necrotising enterocolitis.

Keywords: Bowel hyperechogenicity, congenital syphilis; necrotising enterocolitis; prematurity.

---

Konjenital sifiliz ile prenatal barsak hiperekojenitesi ve nekrotizan enterokolit birlikteliði

Muhittin Celik, Ali Bulbul, Sinan Uslu
Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Çocuk Saðlýðý ve Hastalýklarý Anabilim Dalý, Neonatoloji Bilim Dalý, Ýstanbul

Konjenital sifiliz, treponema pallidum'un vertikal geçiþinden kaynaklanan ciddi bir hastalýktýr. Klinik bulgular gebeliðin evresi, fetüsün gestasyonel haftasý, maternal tedavi ve fetusun immünolojik yanýtýna göre ortaya çýkmaktadýr. Semptomatik yenidoðanlarda; erken doðum, düþük doðum aðýrlýðý, nonimmün hidrops fetalis, nekrotizan enterokolit (NEK), hepatomegali, deri döküntüleri, trombositopeni, hemolitik anemi ve ateþ tespit edilebilir.
Ýkinci trimesterden itibaren barsak hiperekojenite nedeni ile takip edilen, gebeliðin 29. haftasýnda 1,160 gr olarak doðan kýz bebekte postnatal solunum yetmezliði, hepatomegali, anemi ve trombositopeni saptandý. Bebekte ve annesinde Venereal Disease Research Laboratory titreleri pozitif, doðrulama testi olan Treponema pallidum hemaglütinasyon tetkiki reaktifti. Penisilin 10 gün uygulandýktan sonra anemi ve trombositopeni düzeldi. Postnatal 15. günde aniden perfore nekrotizan NEK geliþtiði görüldü. 3 kez NEK nedeniyle cerrahi müdahale yapýlmasýna raðmen klinik ve laboratuvar bulgular düzelmeyen hasta yaþamýn 54. gününde kaybedildi. Konjenital sifilizin hem prenatal baðýrsak hiperekojenitesi hem de NEK nedeni olduðu kanýsýndayýz. (SETB-2018-08-113)

Anahtar Kelimeler: Barsak hiperekojenitesi, konjenital sifiliz, nekrotizan enterokolit, erken doðum

---

CITE