An analysis of the clinical features of children with early congenital Syphilis and Syphilitic Hepatitis

Abstract Background The infection rate of congenital syphilis is gradually increasing, the clinical manifestations of some children with congenital syphilis are abnormal liver function, which is given the clinical diagnosis of syphilitic hepatitis. At present, there are few studies on the clinical features of children with early congenital syphilis combined with syphilitic hepatitis, so we set out to do such a study. We compared the liver function indicators before and after the treatment of syphilis to find the clinical features that can provide guidance for clinical diagnosis and treatment. Methods This study collected clinical data on 51 children with early congenital syphilis combined with syphilitic hepatitis in Beijing Ditan Hospital, affiliated with Capital Medical University, between April 2014 and October 2019. We observed their age, gender, clinical symptoms, and physical symptoms, as well as the pregnancy and childbirth history of their mothers. We also compared the liver function indicators before and after the treatment of the syphilis and analyzed the children’s clinical features. Results The results of this study showed that the clinical manifestations in children with early congenital syphilis combined with syphilitic hepatitis were diverse. The most common clinical manifestation was anemia (56.9 %), followed by syphilitic rash (54.9 %), hands, feet, and whole-body peeling (35.3 %), and splenomegaly (29.4 %). Liver damage caused by a syphilis infection tends to result in elevated alanine aminotransferase, aspartate aminotransferase, and bilirubin, while albumin decreases. After the syphilis treatment, the liver function indexes were significantly improved compared with before treatment, and the difference was statistically significant (all p < 0.05). Conclusions A child with abnormal liver function, especially with anemia, skin rash, peeling, abdominal distension, and hepatosplenomegaly should be highly suspected of having a syphilis infection. Once the diagnosis is made, the appropriate standard penicillin treatment should be started as soon as possible to improve the condition and prognosis of the child.

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Clinical Features of COVID-19-Related Liver Damage

10.1101/2020.02.26.20026971 ◽

2020 ◽

Cited By ~ 36

Author(s):

Zhenyu Fan ◽

Liping Chen ◽

Jun Li ◽

Cheng Tian ◽

Yajun Zhang ◽

...

Keyword(s):

Length Of Stay ◽

Liver Function ◽

Clinical Features ◽

Liver Damage ◽

Science And Technology ◽

Clinical Manifestations ◽

Normal Liver ◽

Abnormal Liver Function ◽

Liver Functions ◽

Function Group

AbstractBACKGROUNDA recent outbreak of SARS-CoV-2 infection occurs mainly in China, with rapidly increasing the number of cases (namely COVID-19). Abnormal liver functions are frequently present in these patients, here we aimed to clarify the clinical features of COVID-19-related liver damage to provide some references for the clinical treatment.METHODSIn this retrospective, single-center study, we included all confirmed COVID-19 cases in Shanghai Public Health Clinical Center from January 20 to January 31, 2020. The outcomes were followed up until February 19, 2020. A total of 148 cases were analyzed for clinical features, laboratory parameters (including liver function tests), medications and the length of stay.FINDINGSOf 148 confirmed SARS-CoV-2-infected patients, 49.3% were females and 50.7% were males. The median age was 50.5 years (interquartile range, 36-64). Patients had clinical manifestations of fever (70.1%), cough (45.3%), expectoration (26.7%) at admission. 75 patients (50.7%) showed abnormal liver functions at admission. Patients (n = 75) who had elevated liver function index were more likely to have a moderate-high degree fever (44% vs 27.4%; p = 0.035) and significantly present in male patients (62.67% vs 38.36%; p = 0.005). The numbers of CD4+ and CD8+ T cells were significantly lower in abnormal liver function group than those in normal liver function group. There was no statistical difference in prehospital medications between normal and abnormal liver function groups, while the utilization rate of lopinavir/ritonavir after admission was significantly higher in patients with emerging liver injury than that in patients with normal liver functions. Importantly, the emerging abnormal liver functions after admission caused a prolonged length of stayINTERPRETATIONSARS-CoV-2 may cause the liver function damage and the Lopinavir/ritonavir should be applied carefully for the treatment of COVID-19.FUNDINGShanghai Science and Technology Commission Fund Project and National Science and Technology Major Project

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INFLUENCE SIFILITIC IN PREGNANT WOMEN ON THE HEALTH OF NEWBORN CHILDREN

Russian Journal of Skin and Venereal Diseases ◽

10.18821/1560-9588-2017-20-3-188-192 ◽

2017 ◽

Vol 20 (3) ◽

pp. 188-192

Author(s):

Natalya Vladimirovna Matyskina ◽

T. E Taranushenko ◽

Yu. V Karacheva

Keyword(s):

Child Health ◽

Pregnant Women ◽

Clinical Features ◽

High Mortality ◽

Clinical Symptoms ◽

Congenital Syphilis ◽

Pathological Process ◽

Newly Diagnosed ◽

Syphilis Infection ◽

Mucous Membranes

A particular challenge for child health represent cases of early and congenital syphilis, which is characterized by a severe multiorgan pathology in children and high mortality in newborns. Purpose. To study the incidence of early congenital syphilis, depending on the time of detection of syphilis infection in women and to present the clinical features of this disease in newborns with the frequency of the detection of the most important specific manifestations of the disease. Material and methods. We observed 114 women with confirmed syphilis infection and newborns from these mothers. Results. The data presented indicate the prevalence of Lues latens praecox in the structure of syphilis infection in pregnant women with newly diagnosed disease. In children from women who were diagnosed with syphilis during this pregnancy early congenital syphilis (PBC) exhibited in 74.3% of cases, while 27 cases in 19 newborns syphilis was accompanied by clinical symptoms. Conclusion. In the pathological process in congenital syphilis, with greatest frequency involved bone, followed - mucous membranes (rhinitis).

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Syphilis Infection during Pregnancy: Fetal Risks and Clinical Management

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/2012/430585 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 53

Author(s):

Marco De Santis ◽

Carmen De Luca ◽

Ilenia Mappa ◽

Terryann Spagnuolo ◽

Angelo Licameli ◽

...

Keyword(s):

Congenital Syphilis ◽

Clinical Manifestations ◽

Fetal Loss ◽

Immunological Response ◽

Maternal Infection ◽

Serological Tests ◽

Syphilis Infection ◽

Serological Screening ◽

Adequate Treatment ◽

Adverse Pregnancy

Congenital syphilis is still a cause of perinatal morbidity and mortality. Untreated maternal infection leads to adverse pregnancy outcomes, including early fetal loss, stillbirth, prematurity, low birth weight, neonatal and infant death, and congenital disease among newborns. Clinical manifestations of congenital syphilis are influenced by gestational age, stage of maternal syphilis, maternal treatment, and immunological response of the fetus. It has been traditionally classified in early congenital syphilis and late congenital syphilis. Diagnosis of maternal infection is based on clinical findings, serological tests, and direct identification of treponemes in clinical specimens. Adequate treatment of maternal infection is effective for preventing maternal transmission to the fetus and for treating fetal infection. Prenatal diagnosis of congenital syphilis includes noninvasive and invasive diagnosis. Serological screening during pregnancy and during preconception period should be performed to reduce the incidence of congenital syphilis.

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Clinical Study of Autonomic Dysfunction in Patients With Anti-NMDA Receptor Encephalitis

Frontiers in Neurology ◽

10.3389/fneur.2021.609750 ◽

2021 ◽

Vol 12 ◽

Author(s):

Lulu Yan ◽

Shuang Zhang ◽

Xiaoxue Huang ◽

Yao Tang ◽

Jun Wu

Keyword(s):

Mechanical Ventilation ◽

Liver Function ◽

Clinical Features ◽

Autonomic Dysfunction ◽

Sinus Tachycardia ◽

Abnormal Liver Function ◽

Common Symptom ◽

Icu Admission ◽

Nmdar Encephalitis ◽

Number Of Patients

Objectives: Autonomic dysfunction is a common symptom of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis; however, it has been poorly researched. The purpose of this study was to compare the clinical features, tumor occurrence, intensive care unit (ICU) admission, mechanical ventilation, imaging assessment, cerebrospinal fluid examination, disease severity, and immunotherapy in patients with anti-NMDAR encephalitis with or without autonomic dysfunction.Methods: A retrospective study of anti-NMDAR encephalitis patients diagnosed between January 2016 and April 2020 was performed at the First Affiliated Hospital of Zhengzhou University. Patients were divided into two groups according to whether they had autonomic dysfunction, and their clinical features, treatment, and prognosis were compared.Results: A total of 119 patients with anti-NMDAR encephalitis were included in this study. Seventy-three patients (61.3%) had autonomic dysfunction, while the remaining 46 (38.7%) did not. Sinus tachycardia (69.9%) was the autonomic dysfunction with the highest incidence, while the incidences of symptoms including constipation, central hypopnea, and others gradually decreased. Compared to the group without autonomic dysfunction, the prevalence of the main clinical symptoms such as epileptic seizure (P = 0.003), involuntary movement (P = 0.028), and decreased consciousness (P < 0.001) were higher in the group with autonomic dysfunction, which also more frequently presented with complications such as pulmonary infection (P < 0.001) and abnormal liver function (P = 0.001). Moreover, the rates of ICU admission (P < 0.001) and mechanical ventilation (P = 0.001), as well as the modified Rankin scale (mRS) scores at admission (P < 0.001), maximum mRS scores during the course of disease (P < 0.001), and mRS scores at discharge (P < 0.001) were higher in the patients with autonomic dysfunction than in those without. The number of patients in the autonomic dysfunction group who underwent ≥2 immunotherapies was also higher than that in the group without autonomic dysfunction (P < 0.001).Conclusion: Sinus tachycardia is the most common type of autonomic dysfunction in anti-NMDAR encephalitis. Compared to patients without autonomic dysfunction, those with autonomic dysfunction had a higher incidence of epilepsy, involuntary movements, decreased consciousness, pulmonary infections, abnormal liver function, ICU admissions, and mechanical ventilation; moreover, the severity of the disease was greater, and their prognosis worse. Therefore, such patients require intensive immunotherapy.

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The Clinical Diagnosis of Congenital Syphilis

Journal of Mental Science ◽

10.1192/bjp.76.314.496 ◽

1930 ◽

Vol 76 (314) ◽

pp. 496-504

Author(s):

R. M. Stewart

Keyword(s):

Clinical Diagnosis ◽

Relative Frequency ◽

Mental Hospital ◽

Congenital Syphilis ◽

Clinical Manifestations ◽

The Body

Late congenital syphilis, with which this précis is concerned, is not always easy to recognize, as unquestionably the disease has altered in severity during the last few decades, and it is now rather exceptional to find cases which exhibit all the cardinal signs. In the following account, which is based on the examination of nearly 200 cases in the Leavesden Mental Hospital, the clinical manifestations have as far as possible been grouped under the various systems of the body and it has been thought advisable to include, not only the classical and unequivocal stigmata, but also those which, though not exactly specific, are yet of sufficient importance to evoke a suspicion of syphilis. Their relative frequency is shown in the accompanying table.

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A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series

Frontiers in Medicine ◽

10.3389/fmed.2021.681668 ◽

2021 ◽

Vol 8 ◽

Author(s):

Panpan Liu ◽

Juan Su ◽

Xuanwei Zheng ◽

Mingliang Chen ◽

Xiang Chen ◽

...

Keyword(s):

Cell Carcinoma ◽

Clinical Diagnosis ◽

Clinical Features ◽

Malignant Tumors ◽

Clinical Manifestations ◽

Concordance Rate ◽

Histological Evaluation ◽

Histopathological Diagnosis ◽

Melanocytic Nevi ◽

Hands And Feet

Purpose: Melanocytic nevi are common cutaneous lesions. This study aimed to demonstrate the concordance and discordance between clinical and histopathological diagnoses of melanocytic nevi and the importance of histological evaluation in differentiating malignant lesions from diseases with similar clinical manifestations.Patients and Methods: We studied 4,561 consecutive patients with a clinical diagnosis of melanocytic nevi from 2014 to 2019. We compared the clinical diagnosis with the histopathological diagnosis to establish a histopathological concordance rate and then investigated the effects of clinical characteristics and the reasons for removal on misclassification.Results: Among 4,561 patients who were clinically diagnosed with melanocytic nevi, the overall histopathological concordance rate was 82.11% (3,745 of 4,561 patients), while the histopathological discordance rate was 17.89% (816 of 4,561 patients). The histopathological concordance included 90.25% common acquired melanocytic nevi (3,380 of 3,745 patients) and 9.75% other benign melanocytic neoplasms (365 of 3,745 patients). The most common diagnostic change was to seborrheic keratosis (n = 470, 10.30%), followed by basal cell carcinoma (n = 64, 1.40%), vascular tumor (n = 53, 1.16%), fibroma (n = 43, 0.94%), epidermoid cyst (n = 34, 0.75%), wart (n = 30, 0.66%), melanoma (n = 24, 0.53%), Bowen's disease (n = 16, 0.35%), squamous cell carcinoma (n = 4, 0.09%), keratoacanthoma (n = 2, 0.04%), and other neoplasms (n = 76, 1.67%). Male sex, old age, location of the lesion, and the reasons for removal have a potential effect on misclassification. The percentages of misclassified lesions on the trunk and limbs and the perineum and buttocks were higher than those in lesions without a change in diagnosis. Importantly, locations of lesions on the head and neck were significantly related to a change in diagnosis to non-melanoma skin cancer, while locations on the hands and feet were significantly related to a change in diagnosis to melanoma. In addition to a typical clinical features, removal due to lesion changes or repeated stimulation was significantly associated with a change in diagnosis to melanoma.Conclusions: Our study emphasizes the clinical differential diagnosis of melanocytic nevi, especially the possibility of malignant tumors. The occurrence of clinical features associated with clinicopathological discordance should raise the clinical suspect and be carefully differentiated from malignant tumors.

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CLINICAL MANIFESTATIONS OF MEASLES IN GENERAL DENTAL PRACTICE

Актуальні проблеми сучасної медицини Вісник Української медичної стоматологічної академії ◽

10.31718/2077-1096.19.2.155 ◽

2019 ◽

Vol 19 (2) ◽

pp. 155-158

Author(s):

T.D. Bublii ◽

L.I. Dubovaya

Keyword(s):

Clinical Diagnosis ◽

Nasal Congestion ◽

Clinical Manifestations ◽

Early Period ◽

General Tendency ◽

Educational Work ◽

Prodromal Phase ◽

Before And After ◽

Palate Mucosa ◽

Dental Professional

Despite of general tendency towards the decrease in the incidence of measles and rubella in recent years, there have been registered several outbreaks of these infections among young adults and adolescents at present. This case report describes a clinical case of measles suspected at the dental examination. The aim of this study is to make a clinical diagnosis of the patient and to draw attention of the dental professional and general physicians to the relevance of this problem. The prodromal phase of measles can be quite variable and mimic the clinical picture of other diseases, as it happened in our case, when the patient went to the dental office for symptoms of acute serous periodontitis. Belsky — Filatov — Koplik’s spots are reported to usually appear in 37.7-64.3% of cases (at the beginning of the measles rash period). In 57.5% of cases there is spot enanthema on the soft palate mucosa. Our patient presented only signs of acute catarrhal stomatitis. We would like to emphasize that 100% of patients with measles have catarrhal syndrome manifested with moderate signs of nasopharyngitis (nasal congestion, sore throat, dry cough), and only 42.8% suffer from conjunctivitis. This makes it difficult to diagnose this disease in its early period or to make differential diagnosis in the prodromal phase. An infected person can transmit the virus within 4 days before and after the rash appears that is very dangerous for surrounding people and for healthcare workers in particular. When making a diagnosis, it is important to remember that measles is a clinical diagnosis, and there is no opportunity to carry out an indicative rapid diagnosis (as with the flu), therefore every doctor should consider the issue of timely vaccination, and promotes preventive and educational work among the population.

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