[Acute hepatic insufficiency disclosing congenital syphilis].
A breast-fed boy, born to first-cousin parents, had been vomiting since birth; his general condition remained good until age 6 weeks when vomiting became more frequent, and his status suddenly worsened, with polypnea, shock, hypothermia, jaundice, presence of blood in urine, gastric juice, stool, and bleeding tendency during veno-punctures. There was an huge hepatomegaly and a splenomegaly. Hypoglycaemia, metabolic acidosis, severe blood coagulation disturbances, elevated liver enzymes, hypoalbuminemia, pointed to an acute liver failure. He was resuscitated with current supportive measures, and was given a wide spectrum antibiotherapy. Because serologic tests for syphilis were positive in the child and his mother, including the presence of specific IgM the infant was then given Penicillin G therapy only, which resulted in a complete recovery. One month later, a needle liver biopsy showed residual signs of hepatitis. Other possible infectious or metabolic causes of acute liver failure occurring early in life had been excluded.
Service de Pédiatrie, Hôpital de la Salpêtrière, Paris.
G
G
Noseda
C
C
Roy
P
P
Phan
J P
JP
Harpey
D
D
Rogrigue
M H
MH
Binet
C
C
Vaur
B
B
Caille
D000208:Acute Disease; D000583:Amikacin / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000209:etiology; D002439:Cefotaxime / Q000627:therapeutic use; D003241:Consanguinity; D005260:Female; D006529:Hepatomegaly; D006801:Humans; D007231:Infant, Newborn; D008107:Liver Diseases / Q000151:congenital* / Q000628:therapy; D008297:Male; D010400:Penicillin G / Q000627:therapeutic use; D011247:Pregnancy; D013588:Syphilis Serodiagnosis; D013590:Syphilis, Congenital / Q000150:complications* / Q000628:therapy; D014839:Vomiting / Q000209:etiology
D000583:Amikacin; D002439:Cefotaxime; D010400:Penicillin G
Insuffisance hépatique aiguë révélant une syphilis congénitale.