Journal Article 妊娠初期に梅毒血清反応検査陰性であった母体より出生した先天梅毒の一例
A case of congenital syphilis despite a negative maternal serologic test for syphilis

高清水, 奈央  ,  安達, 裕行  ,  伊藤, 誠人  ,  高橋, 勉  ,  太田, 翔三  ,  新井, 浩和  ,  下田, 勇樹  ,  三浦, 広志  ,  佐藤, 朗

44 ( 1 )  , pp.51 - 55 , 2017-06-30 , 秋田医学会
Despite a negative result for syphilis in a maternal serological test in the first trimester, we experienced a case of congenital syphilis. The mother was a 23-year-old primipara who had been undergoing regular prenatal care since early pregnancy ; a serological syphilis test at 10 weeks of gestation was negative. She was admitted to our hospital with preterm labor, fever, liver dysfunction, and skin rash at 29 weeks of gestation. Her fetus had ascites and hepatomegaly, although the cause was unclear. The mother delivered a male infant by emergency C-section at 32 weeks of gestation due to concerns over fetal status. The neonate had severe persistent pulmonary hypertension. He also had epidermolysis, hepatomegaly, and thrombocytopenia. CRP value and serum IgM level were abnormally elevated. Considering the clinical findings, and the mother’s previous medical history, we checked the serological syphilis tests for both infant and mother. As both tests were positive, we made a diagnosis of congenital syphilis and commenced treatment with penicillin. Treatment was effective and the patient was discharged from the neonatal intensive care unit at 75 days of age ; developmental follow-up is ongoing. Our case shows that even if a syphilis test is negative during the first trimester, it is important to consider congenital syphilis in infants with suspicious clinical findings.

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