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Early Congenital SyphilisEarly congenital syphilis Early congenital syphilis is defined as syphilis acquired in utero that becomes symptomatic during the first 2 years of life. It usually appears in the first week of life. The findings can be viewed as an exaggeration of those of acquired secondary syphilis. The majority of syphilitic babies are born apparently healthy. Others present with, feeble, emaciated bodies. The sallow or jaundiced skin is wrinkled and flabby, giving the child a prematurely old look. After four, six, or eight weeks of apparent robustness, the child may develop a nasal catarrh. Syphilitic rhinitis is called snuffles. The child breaths through the mouth. This greatly interferes with nursing and respiration. A mucopurulent or bloody secretion is usually present. Ulcers and fissures appear at the orifices of the body, especially at the mouth and anus. This may be followed by ulceration and necrosis of the nasal bones, resulting in a depression at its base creating the so called saddle nose. The catarrh may extend to the middle ear, giving rise to otitis media, followed by deafness and otorrhea. There may be enlargement of the liver and spleen. Disease of the bones is often seen, with separation of their epiphyses. Erythema, eczematous patches, or papules are common. They have the characteristic coppery color found in the lesions of secondary syphilis. The hair on the head and eyebrows may fall out, while the finger-tips become red and inflamed, and the nails finally separate and fall off. Ulcers or fissures about the mouth appear and are highly infectious. Members of the family may become infected by kissing and fondling the child. |