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Article in Japanese

Diagnosing Treponema pallidum in congenital syphilis by PCR using the endotracheal aspiration sample: A case report

Takafumi IGUCHI1), Eri NAKATANI1), Shinobu YOSHIDA1)

Cases of congenital syphilis are increasing, due to the rising number of syphilis-diagnosed young females. This study reports a 0-day-old female infant with congenital syphilis. She was born via vaginal delivery at a gestational age of 34 weeks and 3 days, with a body weight of 2,108g and Apgar scores of 3 and 6 at 1 and 5 minutes, respectively. She was admitted to the Neonatal Intensive Care Unit, due to preterm birth, low birth weight, severe neonatal asphyxia and respiratory failure. Diagnosis of congenital syphilis was made because of symmetrical skin peeling of all four extremities. Splenomegaly also was observed at birth and blood tests revealed rapid plasma reagent- and treponema pallidum hemagglutination-positive results, then treatment with benzylpenicillin was conducted. The newborn had persistent pulmonary hypertension concurrently, and showed exacerbation of her respiratory status, due to atelectasis, while undergoing inhaled nitric oxide therapy under mechanical ventilation at 2 days old. Therefore, sputum removal was performed by using bronchoscopy. In samples collected at that time, Treponema pallidum (T. pallidum) was detected by the polymerase chain reaction method. Treatment with benzylpenicillin was continued until 15 days after birth, and the newborn was discharged when she was 53 days old. Since the number of congenital syphilis cases is still small but increasing, neonatologists and pediatricians should keep this disease in mind and perform early diagnosis and treatment. In addition, it is desirable to notify all staff to take thorough standard precautions during treatment of infants with congenital syphilis.

1) Department of Pediatrics, Omihachiman Community Medical Center

Key words congenital syphilis, persistent pulmonary hypertension (PPHN), endotracheal aspiration sample, polymerase chain reaction (PCR)
Received March 14, 2019
Accepted August 14, 2019

31 (4):355─360,2019