Non-immune fetal hydrops fetalis with poor outcome: congenital Treponema infection. Case report
Non-immune fetal hydrops fetalis (NIPH) is defined as the presence of edema in the fetal skin and cavities, without evidence of antibodies against erythrocyte antigens. Its prevalence is 1/2,500-4,000 births. Among the infectious causes, the main differential diagnosis is with Parvovirus B19 (h...
| Autores principales: | , , , , , , , |
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2022
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/39005 |
| Aporte de: |
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I10-R327-article-39005 |
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ojs |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
non-immune hydrops treponema congenital syphilis hidrops no inmune treponema sifilis congenita |
| spellingShingle |
non-immune hydrops treponema congenital syphilis hidrops no inmune treponema sifilis congenita Boes , M. Ortiz, E Boggio, G DiCuatro, N Miranda, MT Pedranti, M Adamo, MP Moreno, L Non-immune fetal hydrops fetalis with poor outcome: congenital Treponema infection. Case report |
| topic_facet |
non-immune hydrops treponema congenital syphilis hidrops no inmune treponema sifilis congenita |
| author |
Boes , M. Ortiz, E Boggio, G DiCuatro, N Miranda, MT Pedranti, M Adamo, MP Moreno, L |
| author_facet |
Boes , M. Ortiz, E Boggio, G DiCuatro, N Miranda, MT Pedranti, M Adamo, MP Moreno, L |
| author_sort |
Boes , M. |
| title |
Non-immune fetal hydrops fetalis with poor outcome: congenital Treponema infection. Case report |
| title_short |
Non-immune fetal hydrops fetalis with poor outcome: congenital Treponema infection. Case report |
| title_full |
Non-immune fetal hydrops fetalis with poor outcome: congenital Treponema infection. Case report |
| title_fullStr |
Non-immune fetal hydrops fetalis with poor outcome: congenital Treponema infection. Case report |
| title_full_unstemmed |
Non-immune fetal hydrops fetalis with poor outcome: congenital Treponema infection. Case report |
| title_sort |
non-immune fetal hydrops fetalis with poor outcome: congenital treponema infection. case report |
| description |
Non-immune fetal hydrops fetalis (NIPH) is defined as the presence of edema in the fetal skin and cavities, without evidence of antibodies against erythrocyte antigens. Its prevalence is 1/2,500-4,000 births. Among the infectious causes, the main differential diagnosis is with Parvovirus B19 (high tropism for erythroid cells and development of fetal anemia) although cases related to other infections have been described. It is report a case of HFNI with postmortem diagnosis by anatomic pathology caused by Treponema/syphilis.
23-year-old primigest, uncontrolled pregnancy. She consulted at 26 weeks of gestation (uterine height), normotensive, with no alterations in physical examination; ultrasound control: "single fetus, alive and mobile. Placenta of posterior insertion, homogeneous, normal amniotic fluid". Routine studies/surveys were requested (she did not return). At 31 weeks of gestation. Ultrasound: "Fetal movements and fetal heartbeat negative". Expulsion of dead fetus with generalized subcutaneous edema. Studies: group and factor: B Rh+, direct Coombs negative. Irregular antibodies negative. Rapid test for syphilis positive. VDRL Reactive 32 dils. Other serologies Negative. Pathological anatomy: generalized fetal epidermolysis and placenta with changes related to erythroblastosis and chorioamnionitis, compatible with infection by Treponema (HFNI). Warthin Starry staining was performed where spirochetes were visualized.
It is reported a case of NIPH with poor evolution associated to congenital syphilis. Although hydrops is a rare entity to diagnose, being even less frequent its association with Treponema infection, we reinforce the importance of prenatal controls and screening for an early diagnosis of a prevalent and easy to treat disease.
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| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2022 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/39005 |
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2024-09-03T21:03:56Z |
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I10-R327-article-390052024-04-15T16:14:45Z Non-immune fetal hydrops fetalis with poor outcome: congenital Treponema infection. Case report Hidrops fetal no inmune de mala evolución: infección congénita por Treponema. Reporte de un caso Boes , M. Ortiz, E Boggio, G DiCuatro, N Miranda, MT Pedranti, M Adamo, MP Moreno, L non-immune hydrops treponema congenital syphilis hidrops no inmune treponema sifilis congenita Non-immune fetal hydrops fetalis (NIPH) is defined as the presence of edema in the fetal skin and cavities, without evidence of antibodies against erythrocyte antigens. Its prevalence is 1/2,500-4,000 births. Among the infectious causes, the main differential diagnosis is with Parvovirus B19 (high tropism for erythroid cells and development of fetal anemia) although cases related to other infections have been described. It is report a case of HFNI with postmortem diagnosis by anatomic pathology caused by Treponema/syphilis. 23-year-old primigest, uncontrolled pregnancy. She consulted at 26 weeks of gestation (uterine height), normotensive, with no alterations in physical examination; ultrasound control: "single fetus, alive and mobile. Placenta of posterior insertion, homogeneous, normal amniotic fluid". Routine studies/surveys were requested (she did not return). At 31 weeks of gestation. Ultrasound: "Fetal movements and fetal heartbeat negative". Expulsion of dead fetus with generalized subcutaneous edema. Studies: group and factor: B Rh+, direct Coombs negative. Irregular antibodies negative. Rapid test for syphilis positive. VDRL Reactive 32 dils. Other serologies Negative. Pathological anatomy: generalized fetal epidermolysis and placenta with changes related to erythroblastosis and chorioamnionitis, compatible with infection by Treponema (HFNI). Warthin Starry staining was performed where spirochetes were visualized. It is reported a case of NIPH with poor evolution associated to congenital syphilis. Although hydrops is a rare entity to diagnose, being even less frequent its association with Treponema infection, we reinforce the importance of prenatal controls and screening for an early diagnosis of a prevalent and easy to treat disease. Se define hidrops fetal no inmune (HFNI) a la presencia de edema en piel y cavidades fetales, sin evidencia de anticuerpos contra antígenos eritrocitarios. Su prevalencia es de 1/2.500-4.000 nacimientos. Entre las causas infecciosas, el principal diagnóstico diferencial se realiza con Parvovirus B19 (alto tropismo por células eritroides y desarrollo de anemia fetal) aunque se describen casos relacionados con otras infecciones. Se reporta un caso de HFNI con diagnóstico postmortem por anatomía patología causado por Treponema/sífilis. Primigesta de 23 años, embarazo no controlado. Consulta a las 26 semanas de gestación (altura uterina) normotensa, sin alteraciones en examen físico; control ecográfico: "feto único, vivo y móvil. Placenta de inserción posterior homogénea, líquido amniótico normal”. Se solicitan estudios/pesquisas de rutina ( no regresa). A las 31 semanas de gestación. Ecografía: “Movimientos fetales y Latidos cardíacos fetales negativos". Expulsión de feto muerto con edema subcutáneo generalizado. Estudios: grupo y factor: B Rh+, Coombs directa Negativa. Anticuerpos irregulares negativos. Test rápido para sífilis positivo. VDRL Reactiva 32 dils. Resto de serologías Negativas. Anatomía patológica: epidermolisis generalizada fetal y placenta con cambios vinculables a eritroblastosis y corioamnionitis, compatibles con infección por Treponema (HFNI). Se realiza tinción de Warthin Starry donde se visualizan espiroquetas. Se reporta un caso de HFNI con mala evolución asociado a sífilis congénita. Si bien la hidropesía es una entidad rara de diagnosticar, siendo aún menos frecuente su asociación con infección por Treponema, reforzamos la importancia de los controles y pesquisa prenatal para un diagnóstico precoz de una enfermedad prevalente y de fácil tratamiento. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2022-10-26 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto https://revistas.unc.edu.ar/index.php/med/article/view/39005 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 79 No. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 79 Núm. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista da Faculdade de Ciências Médicas de Córdoba; v. 79 n. Suplemento JIC XXIII (2022): Suplemento JIC XXIII 1853-0605 0014-6722 Derechos de autor 2022 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0 |