Syphilis may be acquired in utero. The
mother becomes infected within 5 years before the pregnancy.
Visit: Pathology
of Syphilis
;
Neurosyphilis
;
Bejel
;
Yaws
After about the fourth month of
gestation, spirochetes in the maternal blood cross the placenta and
invade the faetus.
Infection may cause abortion or
stillbirth or may remain inapparent for months or years. Infants also
may be infected by contact with maternal lesions at the time of birth.
Patients with congenital syphilis have
lesions in the skin, mucous membranes, bone, teeth, liver, lung, and
central nervous system.
The rash may be of any type,
including vesicular, bullous, and may be so severe that the epidermis
sloughs.
Target sites are anus, vulva,
palms, soles, and mouth. The dermal vessels show luetic vasculitis and the epidermis teems with spirochetes.
Spirochetes invade and grow in many
fetal organs and tissues.
Damage to bones and reconstruction by
periosteum causes two characteristic lesions.
The first is a depressed deformity of
the bridge of the nose (saddle nose), and the second is anterior
bowing of the tibias (saber shins).
Infection of the enamel causes notched
incisors (Hutchinson’s teeth). In the liver large areas of parenchymal
cells are separated by loose fibrous connective tissue (hepar lobatum).
Interstitial fibrosis and inflammatory
cells in the lung (pneumonia alba) may prevent adequate pulmonary
expansion and aeration.
Spirochetes may infect the cornea, the
optic nerve, and the eighth cranial nerve.
Penicillin arrests syphilis in all
stages. Tetracycline is given to patients allergic to penicillin.
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