Pituitary gland gumma in congenital syphilis after failed maternal treatment: a case report.

Abstract:

:A preterm, very low birth weight infant was born to a mother with early latent syphilis who was treated 10 days and 3 days before delivery with 2.4 mU of benzathine penicillin. The infant had clinical, laboratory, and radiographic abnormalities consistent with congenital syphilis, ie, a Venereal Disease Research Laboratory test titer that was fourfold greater than was the maternal titer, hepatosplenomegaly, abnormal liver function tests, pneumonitis, osteochondritis of the long bones, and cerebrospinal fluid (CSF) examination showing a reactive Venereal Disease Research Laboratory test, pleocytosis, and elevated protein content. The infant died on the third day of life, and an autopsy revealed an evolving gumma of the anterior pituitary. Immunoglobulin M immunoblotting of serum and CSF was positive, and polymerase chain reaction detected Treponema pallidum DNA in endotracheal aspirate and CSF. This case highlights the pathologic abnormalities observed in congenital syphilis and focuses on the rare finding of an evolving anterior pituitary gumma. Furthermore, it documents the failure of maternal syphilis treatment during the last 4 weeks of pregnancy to cure fetal infection and supports the recommendation that all infants born to mothers with syphilis treated during the last 4 weeks of pregnancy should receive penicillin therapy.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Benzick AE,Wirthwein DP,Weinberg A,Wendel GD Jr,Alsaadi R,Leos NK,Zeray F,Sánchez PJ

doi

10.1542/peds.104.1.e4

subject

Has Abstract

pub_date

1999-07-01 00:00:00

pages

e4

issue

1

eissn

0031-4005

issn

1098-4275

journal_volume

104

pub_type

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