Congenital syphilis associated with persistent pulmonary hypertension of the neonate--a clinico-pathological case study.
Congenital syphilis remains a significant clinical problem, especially in developing countries. We report a fatal case of congenital syphilis complicated by persistent pulmonary hypertension and hypoxic ischaemic encephalopathy.


OBJECTIVE
To describe the association of congenital syphilis with persistent pulmonary hypertension of the newborn (PPHN).


METHODS
Case report of a single patient.


RESULTS
Fatal outcome of one baby with congenital syphilis and associated PPHN despite maximal conventional treatment. Histological examination of the lungs revealed pulmonary oedema, intra-alveolar haemorrhages, localised bronchopneumonia and marked interstitial infiltrates of lymphocytes, plasma cells, macrophages and fibroblasts with interstitial fibrosis. Examination of peripheral pulmonary arteries revealed focal excessive muscularisation with increased adventitial connective tissue.


CONCLUSIONS
Reviewing our own experience and available literature, this case study supports the infrequent association of congenital syphilis with PPHN. However, when it occurs, this combination appears to be fatal.


CONCLUSIONS
More research is warranted to clarify the role of inflammatory mediators in congenital syphilis of the lung.
Department of Paediatrics and Child Health, Tygerberg Hospital, W. Cape.
J
J
Smith
J W
JW
Schneider
D000328:Adult; D001344:Autopsy; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary; D000860:Hypoxia / Q000150:complications*; D007231:Infant, Newborn; D008168:Lung / Q000503:physiopathology*; D008297:Male; D010547:Persistent Fetal Circulation Syndrome / Q000175:diagnosis / Q000209:etiology*; D011247:Pregnancy; D012640:Seizures / Q000209:etiology; D013226:Status Epilepticus / Q000150:complications*; D013590:Syphilis, Congenital / Q000150:complications*