Case report: bone alterations of congenital syphilis refractory to treatment in a 7-year-old schoolboy
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Research, Society and Development |
Texto Completo: | https://rsdjournal.org/index.php/rsd/article/view/24851 |
Resumo: | Objectives: To draw attention to the importance of following up children with congenital syphilis and to present an unusual case of bone changes that persisted up to 7 years of life. Methods: Observational, descriptive and retrospective study using medical records review of three patients with congenital syphilis and literature search, using the Uptodate, PubMed, Medline, Lilacs, Scielo databases covering the period from 2015 to 2021. Results: We describe 3 sisters. with congenital syphilis that were diagnosed and treated at birth and the first-born, rescued at age 7, complained of severe pain when moving her lower limbs since age 5 years. At birth he had VDRL 1:4; non-reactive VDRL parent (NR); mother with VDRL 1:16 and inadequately treated during pregnancy. The first-born had metaphyseal alterations and VDRL in negative CSF, being treated with crystalline penicillin for 10 days, however, she did not comply with outpatient follow-up. During this hospitalization, the physical examination showed no alterations, VDRL NR and long bones radiography with lytic image in the left and right legs suggestive of syphilis. Hospitalization was indicated and treatment with crystalline penicillin 50,000 IU/kg/dose was performed, 6/6 hours for 10 days. At 8 years and 4 months, he no longer had bone changes or pain symptoms when walking. In the second pregnancy she had adequate treatment and in the third pregnancy the father was not treated and the mother received only one dose of medication. The two conceptuses contracted congenital syphilis with bone changes at birth which, in the follow-up at 24 months and 6 months of life, respectively, were no longer detected. Conclusions: The follow-up of children with congenital syphilis should be carried out until all clinical, laboratory and radiological alterations disappear. This case series highlights the importance of diagnosing and treating pregnant women and their sexual partner(s) to eliminate mother-to-child transmission as well as the diagnosis at birth of cases of congenital syphilis and adequate treatment and follow-up. |
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Case report: bone alterations of congenital syphilis refractory to treatment in a 7-year-old schoolboyReporte de caso: alteraciones óseas en sífilis congénita refractarias al tratamiento en un escolar de 7 añosRelato de caso: alterações ósseas de sífilis congênita refratária ao tratamento em escolar de 7 anosCongenital syphilisTreponema pallidumBone and bonesSexually transmitted diseases.Sífilis congénitaTreponema pallidumHuesos y huesosEnfermedades sexualmente transmisibles.Sífilis congênitaTreponema pallidumOsso e OssosDoenças sexualmente transmissíveis.Objectives: To draw attention to the importance of following up children with congenital syphilis and to present an unusual case of bone changes that persisted up to 7 years of life. Methods: Observational, descriptive and retrospective study using medical records review of three patients with congenital syphilis and literature search, using the Uptodate, PubMed, Medline, Lilacs, Scielo databases covering the period from 2015 to 2021. Results: We describe 3 sisters. with congenital syphilis that were diagnosed and treated at birth and the first-born, rescued at age 7, complained of severe pain when moving her lower limbs since age 5 years. At birth he had VDRL 1:4; non-reactive VDRL parent (NR); mother with VDRL 1:16 and inadequately treated during pregnancy. The first-born had metaphyseal alterations and VDRL in negative CSF, being treated with crystalline penicillin for 10 days, however, she did not comply with outpatient follow-up. During this hospitalization, the physical examination showed no alterations, VDRL NR and long bones radiography with lytic image in the left and right legs suggestive of syphilis. Hospitalization was indicated and treatment with crystalline penicillin 50,000 IU/kg/dose was performed, 6/6 hours for 10 days. At 8 years and 4 months, he no longer had bone changes or pain symptoms when walking. In the second pregnancy she had adequate treatment and in the third pregnancy the father was not treated and the mother received only one dose of medication. The two conceptuses contracted congenital syphilis with bone changes at birth which, in the follow-up at 24 months and 6 months of life, respectively, were no longer detected. Conclusions: The follow-up of children with congenital syphilis should be carried out until all clinical, laboratory and radiological alterations disappear. This case series highlights the importance of diagnosing and treating pregnant women and their sexual partner(s) to eliminate mother-to-child transmission as well as the diagnosis at birth of cases of congenital syphilis and adequate treatment and follow-up.Objetivos: Llamar la atención sobre la importancia del seguimiento de los niños con sífilis congénita y presentar un caso inusual de alteraciones óseas que persisten hasta los 7 años de vida. Métodos: Estudio observacional, descriptivo y retrospectivo mediante revisión de historias clínicas de tres pacientes con sífilis congénita y búsqueda bibliográfica, utilizando las bases de datos Uptodate, PubMed, Medline, Lilacs, Scielo cubriendo el período 2015 a 2021. Resultados: Describimos 3 hermanas. La sífilis congénita que fue diagnosticada y tratada al nacer y la primogénita, rescatada a los 7 años, se quejaba de fuertes dolores al mover sus miembros inferiores desde los 5 años. Al nacer tenía VDRL 1: 4; padre VDRL no reactivo (NR); madre con VDRL 1:16 y tratada inadecuadamente durante el embarazo. La primogénita presentó alteraciones metafisarias y VDRL en LCR negativo, siendo tratada con penicilina cristalina durante 10 días, sin embargo, no cumplió con seguimiento ambulatorio. Durante esta internación, el examen físico no mostró alteraciones, VDRL NR y radiografía de huesos largos con imagen lítica en pierna izquierda y derecha sugestiva de sífilis. Se indicó ingreso hospitalario y se realizó tratamiento con penicilina cristalina 50.000 UI / kg / dosis, 6/6 horas durante 10 días. A los 8 años y 4 meses ya no presentaba cambios óseos ni síntomas de dolor al caminar. En el segundo embarazo tuvo un tratamiento adecuado y en el tercer embarazo el padre no fue tratado y la madre recibió solo una dosis de medicación. Las dos concepciones contrajeron sífilis congénita con alteraciones óseas al nacer que, en el seguimiento a los 24 meses y 6 meses de vida, respectivamente, dejaron de detectarse. Conclusiones: El seguimiento de los niños con sífilis congénita debe realizarse hasta que desaparezcan todas las alteraciones clínicas, de laboratorio y radiológicas. Esta serie de casos destaca la importancia de diagnosticar y tratar a las embarazadas y su (s) pareja (s) sexual (es) para eliminar la transmisión maternoinfantil, así como el diagnóstico al nacimiento de los casos de sífilis congénita y el tratamiento y seguimiento adecuados.Objetivos: Chamar a atenção para a importância do seguimento das crianças com sífilis congênita e apresentar um caso incomum de alterações ósseas que persistiram até os 7 anos de vida. Métodos: Estudo observacional, descritivo e retrospectivo utilizando revisão de prontuários de três pacientes com sífilis congênita e pesquisa bibliográfica, utilizando como bases de dados o Uptodate, PubMed, Medline, Lilacs, Scielo abrangendo o período de 2015 a 2021. Resultados: Descrevemos 3 irmãs com sífilis congênita que foram diagnosticadas e tratadas ao nascer e a primogênita, resgatada aos 7 anos, apresentava queixa de dor intensa ao movimentar os membros inferiores desde os 5 anos. Ao nascer teve o VDRL 1:4; pai VDRL não reagente (NR); mãe com VDRL 1:16 e inadequadamente tratada na gestação. A primogênita apresentou alterações metafisárias e VDRL no líquor negativo, sendo tratada com penicilina cristalina por 10 dias, entretanto, não cumpriu seguimento ambulatorial. Neste internamento, o exame físico sem alterações, VDRL NR e com radiografia dos ossos longos com imagem lítica em perna esquerda e direita sugestivas de sífilis. Foi indicada internação e realizado tratamento com penicilina cristalina 50.000 UI/kg/dose, de 6/6 horas durante 10 dias. Aos 8 anos e 4 meses já não apresentava mais as alterações ósseas nem sintomas álgicos à deambulação. Na segunda gestação teve tratamento adequado e na terceira gestação o pai não foi tratado e a genitora recebeu apenas uma dose da medicação. Os dois conceptos contraíram sífilis congênita com alterações ósseas ao nascimento que nos seguimentos aos 24 meses e 6 meses de vida, respectivamente, já não foram mais detectadas. Conclusões: O seguimento das crianças com sífilis congênita deve ser realizado até o desaparecimento de todas as alterações clinicas, laboratoriais e radiológicas. Esta série de casos destaca a importância do diagnóstico e tratamento das gestantes e seu(s) parceiro(s) sexuais para eliminar a transmissão de mãe para filho como também do diagnóstico ao nascer dos casos de sífilis congênita e tratamento e seguimento adequado.Research, Society and Development2021-12-31info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://rsdjournal.org/index.php/rsd/article/view/2485110.33448/rsd-v10i17.24851Research, Society and Development; Vol. 10 No. 17; e253101724851Research, Society and Development; Vol. 10 Núm. 17; e253101724851Research, Society and Development; v. 10 n. 17; e2531017248512525-3409reponame:Research, Society and Developmentinstname:Universidade Federal de Itajubá (UNIFEI)instacron:UNIFEIporhttps://rsdjournal.org/index.php/rsd/article/view/24851/21564Copyright (c) 2021 Carla Virginia Vieira Rollemberg; Ana Juliana Pereira Franca Dantas; Izailza Matos Dantas Lopeshttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessRollemberg, Carla Virginia Vieira Dantas, Ana Juliana Pereira Franca Lopes, Izailza Matos Dantas 2022-01-01T11:11:08Zoai:ojs.pkp.sfu.ca:article/24851Revistahttps://rsdjournal.org/index.php/rsd/indexPUBhttps://rsdjournal.org/index.php/rsd/oairsd.articles@gmail.com2525-34092525-3409opendoar:2024-01-17T09:43:16.740143Research, Society and Development - Universidade Federal de Itajubá (UNIFEI)false |
dc.title.none.fl_str_mv |
Case report: bone alterations of congenital syphilis refractory to treatment in a 7-year-old schoolboy Reporte de caso: alteraciones óseas en sífilis congénita refractarias al tratamiento en un escolar de 7 años Relato de caso: alterações ósseas de sífilis congênita refratária ao tratamento em escolar de 7 anos |
title |
Case report: bone alterations of congenital syphilis refractory to treatment in a 7-year-old schoolboy |
spellingShingle |
Case report: bone alterations of congenital syphilis refractory to treatment in a 7-year-old schoolboy Rollemberg, Carla Virginia Vieira Congenital syphilis Treponema pallidum Bone and bones Sexually transmitted diseases. Sífilis congénita Treponema pallidum Huesos y huesos Enfermedades sexualmente transmisibles. Sífilis congênita Treponema pallidum Osso e Ossos Doenças sexualmente transmissíveis. |
title_short |
Case report: bone alterations of congenital syphilis refractory to treatment in a 7-year-old schoolboy |
title_full |
Case report: bone alterations of congenital syphilis refractory to treatment in a 7-year-old schoolboy |
title_fullStr |
Case report: bone alterations of congenital syphilis refractory to treatment in a 7-year-old schoolboy |
title_full_unstemmed |
Case report: bone alterations of congenital syphilis refractory to treatment in a 7-year-old schoolboy |
title_sort |
Case report: bone alterations of congenital syphilis refractory to treatment in a 7-year-old schoolboy |
author |
Rollemberg, Carla Virginia Vieira |
author_facet |
Rollemberg, Carla Virginia Vieira Dantas, Ana Juliana Pereira Franca Lopes, Izailza Matos Dantas |
author_role |
author |
author2 |
Dantas, Ana Juliana Pereira Franca Lopes, Izailza Matos Dantas |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Rollemberg, Carla Virginia Vieira Dantas, Ana Juliana Pereira Franca Lopes, Izailza Matos Dantas |
dc.subject.por.fl_str_mv |
Congenital syphilis Treponema pallidum Bone and bones Sexually transmitted diseases. Sífilis congénita Treponema pallidum Huesos y huesos Enfermedades sexualmente transmisibles. Sífilis congênita Treponema pallidum Osso e Ossos Doenças sexualmente transmissíveis. |
topic |
Congenital syphilis Treponema pallidum Bone and bones Sexually transmitted diseases. Sífilis congénita Treponema pallidum Huesos y huesos Enfermedades sexualmente transmisibles. Sífilis congênita Treponema pallidum Osso e Ossos Doenças sexualmente transmissíveis. |
description |
Objectives: To draw attention to the importance of following up children with congenital syphilis and to present an unusual case of bone changes that persisted up to 7 years of life. Methods: Observational, descriptive and retrospective study using medical records review of three patients with congenital syphilis and literature search, using the Uptodate, PubMed, Medline, Lilacs, Scielo databases covering the period from 2015 to 2021. Results: We describe 3 sisters. with congenital syphilis that were diagnosed and treated at birth and the first-born, rescued at age 7, complained of severe pain when moving her lower limbs since age 5 years. At birth he had VDRL 1:4; non-reactive VDRL parent (NR); mother with VDRL 1:16 and inadequately treated during pregnancy. The first-born had metaphyseal alterations and VDRL in negative CSF, being treated with crystalline penicillin for 10 days, however, she did not comply with outpatient follow-up. During this hospitalization, the physical examination showed no alterations, VDRL NR and long bones radiography with lytic image in the left and right legs suggestive of syphilis. Hospitalization was indicated and treatment with crystalline penicillin 50,000 IU/kg/dose was performed, 6/6 hours for 10 days. At 8 years and 4 months, he no longer had bone changes or pain symptoms when walking. In the second pregnancy she had adequate treatment and in the third pregnancy the father was not treated and the mother received only one dose of medication. The two conceptuses contracted congenital syphilis with bone changes at birth which, in the follow-up at 24 months and 6 months of life, respectively, were no longer detected. Conclusions: The follow-up of children with congenital syphilis should be carried out until all clinical, laboratory and radiological alterations disappear. This case series highlights the importance of diagnosing and treating pregnant women and their sexual partner(s) to eliminate mother-to-child transmission as well as the diagnosis at birth of cases of congenital syphilis and adequate treatment and follow-up. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-12-31 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://rsdjournal.org/index.php/rsd/article/view/24851 10.33448/rsd-v10i17.24851 |
url |
https://rsdjournal.org/index.php/rsd/article/view/24851 |
identifier_str_mv |
10.33448/rsd-v10i17.24851 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://rsdjournal.org/index.php/rsd/article/view/24851/21564 |
dc.rights.driver.fl_str_mv |
https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Research, Society and Development |
publisher.none.fl_str_mv |
Research, Society and Development |
dc.source.none.fl_str_mv |
Research, Society and Development; Vol. 10 No. 17; e253101724851 Research, Society and Development; Vol. 10 Núm. 17; e253101724851 Research, Society and Development; v. 10 n. 17; e253101724851 2525-3409 reponame:Research, Society and Development instname:Universidade Federal de Itajubá (UNIFEI) instacron:UNIFEI |
instname_str |
Universidade Federal de Itajubá (UNIFEI) |
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UNIFEI |
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UNIFEI |
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Research, Society and Development |
collection |
Research, Society and Development |
repository.name.fl_str_mv |
Research, Society and Development - Universidade Federal de Itajubá (UNIFEI) |
repository.mail.fl_str_mv |
rsd.articles@gmail.com |
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1797052701138223104 |