UNRAVELLING THE PUZZLE OF SYPHILIS IN A THREE YEAR OLD

... After Dr. Okpokiri announced the result of the VDRL test (test for syphilis) to the disappointment of Mrs. Oruada, neither of them was positive, he husband turned and gave her an angry look. The fire in his eyes could raze a sky scraper and she saw hell through his eyes that sent chills down her spine and reawakened her conscience to all her accusations and show of distrust for him. She quickly remembered the occasion where she regretted by words and gestures ever knowing her husband and pushing him down along the stairs when he tried to resolve issues with her. All the ugly incidents and her misbehaviour came back to her like the prodigal son and pierced her soul like the silver arrow in Robin hood, emotionally overwhelmed, tears flowed down her prominent cheeks while she cried like an infant hungry for breast milk. She knelt down, buried her head between her husband's laps while resting her elbows on the later and asking for forgiveness from him. Mr. Oruada was moved with pity that he clasped his arm around her neck and wiping her tears with his brown handkerchief and reassuring her of his forgiveness and endless love.

When this sensational episode was over, Mr. Oruada then asked the doctor, how then their child got syphilis if neither of them was responsible. They were adviced to take their time and tactfully inquire from their child or mount a surveillance since unthinkable things happen these days. That afternoon , the parents called little Daniel into their bedroom, gave him a cup of ice cream, the mother called him several pet names, stroke his hair, all in preparation to dig out the secret in him. When they they felt the time was ripe, she now threw the question at him, Who has been touching you here? While indicating his private part with her index finger. Daniel replied immediately, ' Is it not Ivie'. Shocked at his response she was filled with outrage. what? She asked furiously with an impulse that set her in motion to unleash the dragon on Ivie but her husband signalled with his hand asking her tobe calm. They then further asked him to narrate everything she had done to him.

Ivie was their house help, about 16 years of age. She slept in the same room (children's room) with the kids. At midnight, she would carry Daniel in her laps, stroke his penis and when well erect would introduce it into herself. Daniel got used to it that most times he would lie on Ivie and do certain other absurd things which she thought him. This had gone unnoticed by the parents for 7 months before he fell sick. Ivie outrightly denied all allegations levelled against her. She was taken to the hospital to be tested and behold the result was positive for Syphilis. The other story of what became of Ivie is better imagined than told.

SYPHILIS

This is a sexual transmitted disease caused by a gram negative organism called treponema palladium. It can also be transmitted through the placenta from mother to developing fetus during pregnancy.

SIGNS AND SYMPTOMS

The disease if untreated will progress through 3 stages, viz:

• Primary Syphilis 
• Secondary "
• Tertiary     " 

Primary Syphilis is characterised by:

1. A unique painless rash, Chancre on the external genitalia
2. Painless solitary lymph node enlargement 

Secondary Syphilis is characterised by:

1. Bacteremia with associated fever
2. Condyloma latum
3. Generalised lymphadenopathy 
4. Systemic symptoms 
5. Patchy baldness
6. Generalised body rash

Tertiary Syphilis is characterised by:

1. Gummatous lesions affecting the skin and bones 
2. Cardiovascular Syphilis with aortitis (inflammation of the aorta), aortic aneurysm (ballooning of the aorta) and myocarditis (inflammation of heart muscles) 
3. Neurosyphilis with associated General pares is of the insane, visual disturbance, subacute meningitis but may also be asymptomatic (without symptom). 

Effects of Syphilis on the Fetus

• Spontaneous Abortion /Miscarriage 
• Prematurity
• Intrauterine Fetal demise 
• Early infant death

Thank you for reading!