A CONSIDERATION OF TARDY SYPHILIS

H. H. YERINGTON
1914 Archives of Pediatrics & Adolescent Medicine  
During the past two years, since the introduction of salvarsan in this clinic, more than one hundred and fifty luetic infants and children have been observed, and over seventy treated with salvarsan. It is not the object of this paper to give merely a description of the various cases, many of them most interesting, but to discuss two classes of cases, with our results and conclusions. The first group is composed of patients with marked congenital lues, having positive family histories, clinical
more » ... histories, clinical symptoms and triple + Wassermann reactions. The second group is composed of what we consider the marasmic type of luetic infant, as well as children from a year to sixteen years, with late luetic manifestations. In the first, or active group, five typical cases, all under 3 months of age, were observed and treated with salvarsan, four directly and one indirectly. All had positive family histories, triple + serum reports and marked clinical evidences of lues. Three of the cases exhibited snuffles, fissured mouths and ani, and marked maculopapular eruptions ; one child's mouth was a mass of inflammatory areas and patches, and had to be fed by gavage (Figs. 1, 2 and 3 ). These cases were given 1/20 gm. of salvarsan intravenously, and all died within two weeks after treatment. It was of interest to note the rapidity with which the skin symptoms cleared up in each case, and with this a general improve¬ ment for a few days in the infants' condition. Later, however, they all developed a generalized edema, with slight urinary signs, and died. The fourth infant, 4 days old, showed a marked syphilitic pemphigus, covering almost the entire body, and died forty-eight hours after the administration of salvarsan. The last case in this group was a luetic mother with an infected infant 8 weeks old. Two weeks after the child was born, the mother broke out with patches in her mouth and a second¬ ary rash. Six weeks later she came to the clinic with the infant, whose body was covered with a bright red rash. The mother's blood and breastmilk showed a positive serum reaction, and she was given an intravenous injection of 6/10 gm. of salvarsan. For the next three days the child
doi:10.1001/archpedi.1914.04100370049003 fatcat:cejzzmbvujabhcxmoaast4hekq