ABSTRACT
BACKGROUND: Congenital syphilis is a vertical infection caused by Treponema pallidum. Despite the implementation of preventive strategies during pregnancy, its incidence is increasing, and it constitutes an important public health problem. Most patients with congenital syphilis are asymptomatic; however, a small group may develop severe disease at birth with the need of advanced resuscitation in the delivery room, acute hypoxemic respiratory failure, and hemodynamic instability. Therefore, awareness is needed. METHODS AND RESULTS: This series describes the clinical course of two late preterm infants with congenital syphilis who developed acute hypoxemic respiratory failure, pulmonary hypertension, and circulatory collapse early after birth. Integrated hemodynamic evaluation with neonatologist-performed echocardiography (NPE) and therapeutic management is provided. CONCLUSIONS: A comprehensive hemodynamic evaluation including early and serial functional echocardiography in these patients is needed to address the underlying complex pathophysiology and to help to establish accurate treatment.
Subject(s)
Hypertension, Pulmonary , Syphilis, Congenital , Female , Humans , Infant, Newborn , Pregnancy , Echocardiography/methods , Hypertension, Pulmonary/etiology , Hypertension, Pulmonary/physiopathology , Infant, Premature , Pregnancy Complications, Infectious/physiopathology , Pregnancy Complications, Infectious/therapy , Respiratory Insufficiency/etiology , Respiratory Insufficiency/therapy , Shock/etiology , Shock/therapy , Shock/physiopathology , Syphilis, Congenital/complications , Syphilis, Congenital/diagnosis , Syphilis, Congenital/physiopathologyABSTRACT
Se hace una revisión de las alteraciones neurológicas frecuentemente asociadas con la enfermedad celíaca descritas en la literatura. Entre las mismas destaca la elevada prevalencia de crisis convulsivas febriles y epilepsia, tanto generalizada como asociada a calcificaciones cerebrales occipitales bilaterales. También es relevante la asociación con síndromes espino-cerebelosos con ataxia, alteraciones psiquiátricas y de conducta, neuropatía periférica, miopatía inflamatoria, cefalea tanto tensional como migrañosa, síncope vagal, hipotonía muscular y vasculitis cerebral. Se revisa la posible etiopatogenia de tales alteraciones que en dependencia del tipo de manifestación obedecería a factores genéticos, mecanismos inmunológicos o tóxicos o por deficiencia vitamínica o alteración de las aminas biógenas en relación con una alteración malabsortiva intestinal (AU)
Subject(s)
Female , Male , Child , Humans , Celiac Disease/complications , Nervous System Diseases/complications , Spinocerebellar Degenerations/complications , Mental Disorders/complications , Myositis/complications , Seizures, Febrile/complicationsABSTRACT
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