[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.
Noseda
G
G
Service de Pédiatrie, Hôpital de la Salpêtrière, Paris.
Roy
C
C
Phan
P
P
Harpey
J P
JP
Rogrigue
D
D
Binet
M H
MH
Vaur
C
C
Caille
B
B
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.