ПСЕВДОПАРАЛИЧ ПАРРО ПРИ РАННЕМ ВРОЖДЕННОМ СИФИЛИСЕ: КЛИНИЧЕСКИЙ СЛУЧАЙ

И. Х. Белялетдинова, Инна Васильевна Митрофанова, Татьяна Витальевна Кириченко, Е. Н. Абрамова, Т. В. Арсеньева, М. В. Базарова, С. В. Шахгильдян
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Abstract

Background. Congenital syphilis is a severe intrauterine infection which, affecting most of the organs and systems of a child, can lead to his disability. However, it is extremely difficult to suspect congenital syphilis in a child in the absence of information about prior syphilis in his mother. The article presents a case of a monosymptomatic clinical picture of early congenital syphilis. Description of the Clinical Case . At the age of 1 month, the child had hyperemia, isolated edema of the right forearm, and restriction of limb movements. He was examined by a pediatrician who suspected a fracture of the forearm bones. X-ray did not show any fracture. The situation was regarded as an allergic reaction; desensitizing therapy was prescribed during which the range of movements in the right arm slightly increased. At the age of 2 months, there was a decrease in the range of movements in the left arm. On admission, the condition was regarded as moderate one. No fever; no signs of intoxication. Skin and visible mucous membranes were not changed. Cardiopulmonary activity was satisfactory. The abdomen was palpable in all compartments, painless. The liver was enlarged 6 cm, of dense consistency. The spleen was enlarged 5 cm. Bowel and bladder functions were normal. Neurological status: the reaction to examination was adequate, emotional cry. Cranial nerves without pathology. Can see and hear. Restricted range of movements in the arms; passive movements were painful. Muscle tone in the arms was low, in the legs — closer to physiological one. Equal and brisk tendon reflexes from the arms and legs. Large fontanel 1.5[1]1.5 cm, not protruded. X-ray examination of the forearm bones showed a change in the structure of the epiphyses of both forearm bones that was common to syphilitic osteochondritis. Conclusion . The article describes the complexity of diagnosis of early congenital syphilis in a child aged 2 months in the absence of a corresponding anamnesis in his mother. The need to rule out syphilitic infection in infants with motor impairments, born from unexamined mothers, has been emphasized.
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帕罗早期梅毒的假性瘫痪:临床病例
背景。先天性梅毒是一种严重的宫内感染,影响儿童的大部分器官和系统,可导致其残疾。然而,在缺乏其母亲既往梅毒信息的情况下,怀疑儿童患有先天性梅毒是极其困难的。文章提出了一个单症状的早期先天性梅毒的临床图片的情况。临床病例描述。1月龄时,患儿充血,右前臂孤立性水肿,肢体活动受限。一名儿科医生对他进行了检查,怀疑他的前臂骨折。x线未见骨折。这种情况被认为是过敏反应;在进行脱敏治疗期间,右臂的活动范围略有增加。2个月大时,左臂活动范围减小。入院时,病情被视为中度。没有发烧;没有中毒的迹象。皮肤及可见粘膜未见改变。心肺活动令人满意。腹部各隔均可触及,无痛。肝脏增大6cm,呈致密稠度。脾脏肿大5cm。肠道和膀胱功能正常。神经系统状况:检查反应正常,情绪性哭泣。颅神经无病理。能看能听。手臂活动受限;被动的运动是痛苦的。手臂和腿部的肌肉张力较低——更接近生理张力。手臂和腿部的肌腱反射均匀而轻快。大囟门1.5[1]1.5厘米,不突出。前臂骨的x线检查显示两前臂骨骺结构的改变,这是梅毒性骨软骨炎的常见症状。结论。文章描述了复杂性的早期先天性梅毒的诊断在一个2个月大的孩子在没有相应的健全性记忆在他的母亲。有必要排除运动障碍婴儿的梅毒感染,从未经检查的母亲出生,已被强调。
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