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Interstitial keratitis syphilis

Syphilitic interstitial keratitis: treatment with immunosuppressive drug combination therapy Congenital syphilitic keratitis is usually treated with topical steroids and cycloplegic drugs, which not only can be ineffective but can also lead to complications such as cataract and glaucoma The most common etiologies of interstitial keratitis in the United States are Herpes Simplex Virus and Syphilis. Other associated bacterial diseases include Lyme disease, Tuberculosis, Leprosy, Brucellosis, and Leptospirosis Abstract Untreated latent syphilis with interstitial keratitis is not uncommon in the older age group who may present with refractive problems. It is important to investigate these patients with a full range of serological tests for syphilis to determine whether they have been treated adequately in the past Interstitial keratitis is an increasingly uncommon condition that is a manifestation of prenatal syphilis. 1 It is thought to be the result of an immunologic phenomenon directed against treponemal antigens deposited in the cornea

It is unusual for the interstial keratitis that occurs in a congenital luetic to appear before the age of 5 years. This patient was 20 years-old at the time of the photo and had been aware of eye problems for a number of years. The patient had bilateral interstitial keratitis due to her congenital syphilis Interstitial keratitis describes stromal inflammation, characterized by white cell infiltration and edema that can be followed by neovascularization in prenatal syphilis, mumps, herpes simplex, herpes zoster, varicella vaccination, Epstein-Barr virus infection, leprosy, onchocerciasis, and tuberculosis.4 Syphilis of the eye can be a congenital or acquired disease, transmitted sexually. In congenital syphilis, as a rule, the anterior segment of the eye is affected with the development of interstitial keratitis and anterior uveitis, and with acquired syphilis, both anterior and posterior uveitis develop Before the advent of antibiotics, most interstitial keratitis was often caused by syphilis, 10% by sexually acquired syphilis and 90% by congenital syphilis

Regarding the ocular surface, syphilis can cause conjunctivitis, 6 episcleritis or scleritis. 7,8 Interstitial keratitis (See Figure 1), often associated with conjunctival injection and anterior chamber inflammation, is a well-recognized manifestation of congenital syphilis that typically presents between 5 and 20 years of age. 9,10 Dislocation of the crystalline lens may also occur following congenital infection. 1 The association of this disorder with luetic interstitial keratitis has been reported rarely. We report the case of a 58-year-old patient who had unilateral iridoschisis associated with glaucoma and syphilitic interstitial keratitis. We suggest that congenital syphilis might be considered as a cause of iridoschisis. PMID: 8297067 [Indexed for. Interstitial keratitis, a manifestation of certain corneal infections, is rare in the US. Most cases occur in children or adolescents as a late complication of congenital syphilis. Ultimately, both eyes may be involved. A similar but less dramatic bilateral keratitis occurs in Cogan syndrome, Lyme disease, and Epstein-Barr virus infection

Syphilitic interstitial keratitis: treatment with

saddle nose, saber shins, interstitial keratitis and deafness. Congenital syphilis can be asymptomatic, especially in the first weeks of life. Laboratory diagnosis is based upon serological tests of blood and CSF. Reactive tests with nontreponema Interstitial keratitis (IK) is corneal scarring due to chronic inflammation of the corneal stroma. Interstitial means space between cells i.e. corneal stroma which lies between the epithelium and the endothelium. Infectious causes include syphilis (commonest), followed by other bacterial infections. Clinical manifestations of early congenital syphilis might include rhinitis (snuffles), hepatosplenomegaly, skin rash with desquamation, chorioretinitis and pigmentary chorioretinopathy (salt and pepper type), glaucoma, cataracts, interstitial keratitis, optic neuritis, periostitis and cortical demineralization of metaphysis and diaphysis.

Interstitial Keratitis - EyeWik

  1. Interstitial keratitis is a non-ulcerating inflammatory reaction of the corneal stroma that is characterized by non-suppurative infiltration and often stromal vascularization. The epithelium and endothelium are not affected. Scarring due to stromal inflammation and vascularization in interstitial keratitis can result in decreased vision
  2. Syphilis, which is caused by In older children, signs of untreated congenital infection include interstitial keratitis (5-20 years of age), cranial nerve deafness (10-40 years of age), Hutchinson teeth (peg-shaped, notched central incisors), anterior bowing of the shins, frontal bossing, mulberry molars, saddle nose, rhagades (linear scars.
  3. Syphilitic interstitial keratitis is an immune-type response without active bacterial proliferation in the corneal stroma, which responds well to topical steroid treatment , . The interstitial keratitis of congenital syphilis preferentially affects young women (under 30 years of age) ,
  4. Bilateral interstitial keratitis and iridoschisis are reported in four cases with extraocular stigmata of congenital syphilis and positive syphilis serology. The iridoschisis was extensive in two cases giving the iris an unusual ragged appearance, while it was slight in one case

Interstitial keratitis in untreated latent (late) syphili

Interstitial keratitis characteristically forms one of the late manifestations of congenital syphilis. Many a time it may be a part of Hutchinson's triad, which includes: interstitial keratitis, Hutchinson's teeth and vestibular deafness Although Mackenzie,1in 1840, clinically described interstitial keratitis under the heading of scrofulous corneitis, it was not until 1885 that Hutchinson2established with certainty that interstitial keratitis was attributable to congenital syphilis. Few reports relative to the role of trauma in the causation of interstitial keratitis were published prior to 1905, and it was not until Perlia. This case study focuses on keratopathy and chorioretinopathy resulting congenital syphilis. The patient is a 51-year-old man who had diabetes mellitus for eleven years. Furthermore he had interstitial keratitis due to syphilis. Both fundi showed chorioretinal atrophy. The fundus findings were similar to those of retinitis pigmentosa. We examined the visual field, ERG and dark adaptation Interstitial keratitis is an inflammatory condition of the. corneal . stroma. in the absence of primary involvement. of either the corneal epithelium or endothelium. --IK represents a Type IV hypersensitivity reaction to. antigens within the corneal stroma.--Vascular ingrowth is the rule. What does it mean to say the corneal . stroma. is. The Centers for Disease Control and Prevention defines ocular syphilis as clinical symptoms or signs consistent with ocular disease (eg, uveitis, panuveitis, diminished visual acuity, blindness, optic neuropathy, interstitial keratitis, anterior uveitis, or retinal vasculitis) in patients with syphilis of any stage

Syphilitic Interstitial Keratitis JAMA JAMA Networ

Ang Syphilis ng mata ay maaaring maging congenital o nakuha na sakit, na ipinakalat nang sekswal. Sa congenital syphilis karaniwang nangyayari anterior mata segment na may sugat unlad interstitial keratitis at nauuna uveitis, at sa panahon ng pagbili sa syphilis bubuo parehong harap at likod uveitis Interstitial Keratitis in the United States: A study performed by Schwartz et al looked at the causes of IK in the US over a period of 10 years in their cornea service. Their data showed that HSV is the most common cause of IK in the United States. (Table 1) Table1 : Etiologies of Interstitial Keratitis in the United States in the last 10 year Interstitial keratitis is a nonsuppurative inflammation of the corneal stroma without primary involvement of the epithelium or endothelium. Syphilitic interstitial keratitis was the most common interstitial keratitis in the preantibiotic era. Most cases have been associated with congenital syphilis

Syphilis: congenital interstitial keratitis

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, and tertiary). The primary stage classically presents with a single chancre (a firm, painless, non-itchy skin ulceration usually between 1 cm and 2 cm in diameter. Interstitial keratitis is a late manifestation of congenital syphilis occurring between ages 5 and 25 years. It may occur in patients with or without specific treatment for syphilis. It may occur in patients with or without specific treatment for syphilis Interstitial keratitis Avoid using the term syphilis in the presence of the patient. Use euphemism such as ' the condition may be caused by TPHA or St. Luis disease'. The cornea has diffused stromal haze and on high manifestation there are ghost (empty) vessels in the deep and mid-stroma

Infection of the central nervous system with T. pallidum, as evidenced by manifestations including syphilitic meningitis, meningovascular syphilis, optical involvement including interstitial keratitis and uveitis 1, general paresis, including dementia, and tabes dorsalis Syphilitic interstitial keratitis. 2015. Billable Thru Sept 30/2015. Non-Billable On/After Oct 1/2015. ICD-9-CM 090.3 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 090.3 should only be used for claims with a date of service on or before September 30, 2015

Interstitial Keratitis - an overview ScienceDirect Topic

  1. Sir Jonathan Hutchinson (1828-1913) established the fact that interstitial keratitis is almost always due to congenital syphilis and described a triad consisting of notched incisors, interstitial keratitis, and eighth cranial nerve deafness, which is sudden and usually occurs around 8 to 10 years of age
  2. interstitial keratitis is inflammation of the corneal stroma without primary involvement of the. syphilis, HSV, VZV. interstitial keratitis is assciated w/ Treponema pallidum. syphilis is transmitted by. primary syphilis. a sore or sores at the original site of infection. secondary syphilis. include skin rash, swollen lymph nodes, and fever
  3. - Snuffles of congenital syphilis - Congenital syphilis rash on soles - Facial stigmata of congenital syphilis - Interstitial keratitis in congenital syphilis - Hutchinson teeth - Mulberry molar - Perforated hard palate - Rhagades - Saber shins - Clutton joints - T pallidum darkfield microscopy - Treponema pallidum silver stai
  4. Interstitial keratitis, which is an inflammation of the cornea's connective tissue elements, and usually affects both eyes, can occur as a complication brought on by congenital, or acquired syphilis. IK usually occurs in children older than two years of age

The term interstitial keratitis was coined in the 1800's by Hutchinson for congenital syphilis and unfortunately (from the pathologists perspective) is still used. Incidence/Prevalence: Syphilitic stromal keratitis is the most common manifestation of untreated late congenital syphilis; it occurs in about 20-50% of patients. The prevalence of. Interstitial keratitis. Interstitial keratitis, which is an inflammation of the cornea's connective tissue elements, and usually affects both eyes, can occur as a complication brought on by congenital, or acquired syphilis. IK usually occurs in children older than two years of age Syphilis cases should be reported to DOH using the PHIMS-STD system to enter investigation information including provider case report, laboratory, interview, and occasionally cause interstitial keratitis or deafness. Congenital syphilis can be asymptomatic, especially in the first weeks of life. See the CDC treatment guidelines fo The diagnosis of interstitial keratitis of congenital syphilis was not made until about one month after its onset. One month antedating the appearance of the keratitis, one elbow became the site of a Clutton's joint. There were no other stigmas of congenital syphilis. Correlation of the joint condition with the keratitis would have promoted.

HUTCHISON'S TRIAD - Hutchison's teeth+interstitial keratitis+sensorineural deafness. INFANTILE ALOPECIA OF EYEBROWS - Suggestive of early congenital syphilis. KRISOVSKI'S SIGN - Cicatricial lines radiating from the mouth. LEUKOMELANODERMA - Hypo- and hyperpigmented macules over palms and soles METHODS: Congenital syphilitic keratitis was diagnosed by clinical findings and laboratory tests. The child was unresponsive to traditional treatment; thus, systemic immunosuppressive therapy, which consisted of oral cyclosporine 4 mg/kg/d, 6 days per week, and oral low-dose steroids (fluocortolone 0.8 mg/kg a week, given every other day), was. 90 % cases associated with congenital syphilis; Usually bilateral in congenital syphilis and unilateral in acquired syphilis; Hutchinson's triad: Hutchinson's teeth, vestibular deafness, interstitial keratitis late congenital syphilis - after two years of age, more predictable presentation. craniofacial anomalies such as frontal bossing, saddle nose, and prognathism; dental anomalies (part of Hutchinson triad), such as Hutchinson teeth and perforation of the hard palate; interstitial keratitis (part of Hutchinson triad

Congenital Syphilis Will's p. 384 Congenital Syphilis can cause a myriad of issues in the eyes, External adnexae Dacryocystitis, dacryoadenitis, lymphadenopathy Conjunctiva/sclera Chancre, conjunctivitis, scleritis, gumma Cornea Interstitial keratitis (more common in congenital syphilis) Pupil Light near dissociation, Horner's syndrome Motility Internuclear ophthalmoplegia Lens Cataract. Medical definition of interstitial keratitis: a chronic progressive keratitis of the corneal stroma often resulting in blindness and frequently associated with congenital syphilis Interstitial keratitis is a nonsuppurative immune-mediated inflammation of the corneal stroma. There is no primary involvement of the corneal epithelium or endothelium. During the acute phase, interstitial keratitis is characterized by areas of dense stromal infiltration, deep stromal neovascularization and corneal edema (Figure 3) Early latent syphilis is the period of less than a year from the last blood test. Secondary symptoms can sometimes relapse during the early latent phase. Late latent syphilis is the period greater than a year from the last blood test. It can last for years and even decades with no signs of disease Late congenital syphilitic interstitial keratitis. A50.31 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2021 edition of ICD-10-CM A50.31 became effective on October 1, 2020

Syphilitic interstitial keratitis and glaucoma

Diagnosis: Band keratopathy, Interstitial keratitis. Brief Description: This is a case presentation of a patient with band keratopathy secondary to interstitial keratitis and neurotrophic cornea due to HSV infection. The pathogenesis, etiology, and treatment of band keratopathy is discussed. A differential diagnosis for band keratopathy is given A50.31 is a valid billable ICD-10 diagnosis code for Late congenital syphilitic interstitial keratitis.It is found in the 2021 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2020 - Sep 30, 2021. ↓ See below for any exclusions, inclusions or special notation Interstitial keratitis and anterior tibial bowing (saber shins) may occur or progress despite appropriate therapy Overview of and approach to the vasculitides in adults in patients with Cogan syndrome is characterized by ocular inflammatory lesions, including interstitial keratitis , uveitis, and episcleritis as well as inner ear. The association of this disorder with luetic interstitial keratitis has been reported rarely. We report the case of a 58-year-old patient who had unilateral iridoschisis associated with glaucoma and syphilitic interstitial keratitis. We suggest that congenital syphilis might be considered as a cause of iridoschisis

Interstitial Keratitis is the inflammation the tissue of the cornea, which is the dome-shaped clear cover in the front of the eye. The inflammation of the cornea causes the blood vessels to grow disrupting the vision through the cornea. Interstitial Keratitis is a common cause of blindness in the world. It can be caused by exposure to bacteria. Interstitial keratitis (IK) is nonsuppurative inflammation of corneal stroma without primary involvement of epithelium or endothelium. In most cases the inflammation is an immune mediated process triggered by an appropriate antigen. Immune stromal keratitis manifests as focal, multifocal or diffuse stromal opacities or an immune ring He was the first to describe his triad of medical signs for congenital syphilis: notched incisor teeth, labyrinthine deafness, and interstitial keratitis, which was very useful for providing a firm diagnosis long before Treponema pallidum or the Wassermann test were discovered. Jonathan Hutchinson-Wikipedi

Keratitis, Interstitial – Medical Blog

Ophthalmologic Manifestations of Syphilis - EyeWik

Cornea:Interstitial keratitis is a rare manifestation of ocular syphilis in the post-antibiotic era. The postulated pathophysiology behind this clinical entity is an immunologic phenomenon directed against treponemal antigens deposited in the cornea [27,28] Other described manifestations include lid involvement, episcleritis, vitritis, retinitis, papillitis, interstitial keratitis, acute retinal necrosis, and retinal detachment. Primary optic atrophy is unique to late syphilis (classically described with tabes dorsalis) Interstitial keratitis is an inflammation of the cornea of the eye, which can lead to vision loss. Eighth nerve deafness is deafness that is related to the eighth cranial nerve rather than a problem with the structures of the ear. Obviously congenital syphilis can have serious consequences for the unborn. Syphilis Diagnosi The most effective treatment for syphilis in the mother, as well as congenital syphilis in the infant, is penicillin. In some cases other antibiotics may be used. Interstitial keratitis may be treated with corticosteroid drugs and atropine drops. An ophthalmologist should be consulted Tertiary syphilis ; Tertiary syphilis is responsible for a majority of the morbidity and mortality associated with the disease. The hallmark of tertiary syphilis is the destruction of tissue caused by a response to the presence of treponemal antigens. The three most common forms are neurosyphilis, cardiovascular syphilis and gummatous syphilis

How to Recognize Ocular Syphili

Syphilis is a venereal disease, and a great concern for many in this present world making the understanding of the pathophysiology of syphilis is worthwhile. Interstitial keratitis, lymphadenopathy, hepatosplenomegaly, bone involvement, condylomata, anaemia, Hutchinsonian teeth, eight‐nerve deafness, recurrent arthropathy, neurosyphilis. Interstitial keratitis. Interstitial keratitis involves inflammation of the middle layers of the cornea. Affecting one or both eyes, interstitial keratitis often affects children and adolescents who've had congenital syphilis. It's also known as stromal keratitis because it occurs in this deeper layer of the cornea Syphilis is an infection caused by anaerobic, spirochete bacterium, Treponema pallidum. Syphilis is primarily a sexually transmitted disease. It could also be transmitted through blood transfusion and to a fetus via an infected mother.; The infection has a long course and passes through 3 stages - primary, secondary and tertiary The differential diagnosis for HSK includes other etiologies of infectious interstitial keratitis, such as other viruses (Varicella zoster virus, Epstein-Barr virus), bacteria (syphilis, lyme), fungus, and Acanthamoeba, as well as immune-mediated etiologies, including sarcoidosis and Cogan syndrome

Unilateral iridoschisis associated with syphilitic

Keratitis, Interstitial] Introduction Background. Interstitial keratitis (IK) is a broad, descriptive term that has become synonymous with syphilitic disease. Although syphilis remains the leading cause of IK, various bacterial, viral, parasitic, and autoimmune causes of IK exist. Pathophysiolog Abstract. Purpose. We compared the etiologies of immune stromal keratitis (ISK), also known as interstitial keratitis (IK), in a recent group of patients with active and inactive ISK. Methods. We reviewed the charts of 97 patients seen in the cornea clinic at the University of Minnesota from 1985 through 1994 Syphilitic interstitial keratitis (090.3) ICD-9 code 090.3 for Syphilitic interstitial keratitis is a medical classification as listed by WHO under the range -SYPHILIS AND OTHER VENEREAL DISEASES (090-099) The classic dental manifestations of congenital syphilis are Hutchinson's incisors and mulberry molars. 8 Fig. 4 The disorder usually affects the permanent central incisors and mandibular first molars. The combination of teeth defects, deafness and interstitial keratitis is referred to as Hutchinson's triad

Interstitial Keratitis - Eye Disorders - Merck Manuals

Syphilis control in pregnant women through universal screening and Interstitial keratitis: Usually appears near puberty and eventually becomes bilateral. The cornea develops a ground glass appearance with vascularization of the adjacent sclera. b Interstitial keratitis, an inflammation deep in the cornea, may be caused by congenital syphilis, tuberculosis, herpesvirus infection, or even physical injury to the eye. Affected persons may note that their eyes are painful, tend to water, and are sensitive to light. Treatment is directed at Interstitial keratitis is a type usually caused by congenital syphilis, appearing in children between ages 5 and 15; occasionally it may result from acquired syphilis. In rare cases it may result from tuberculosis or rheumatic infection in other parts of the body Inflammation of the cornea, which may cause blindness (interstitial keratitis). A progressive, disabling, and life-threatening complication involving the brain (neurosyphilis). Deafness. Bone deformities. Antibiotics can prevent progression of the disease in an infected baby. But problems that have already developed may not be reversible

Interstitial Keratitis: Overview, Pathophysiology

•Interstitial keratitis (5 years old -adulthood) -Inflammation of tissue of cornea, can lead to vision loss •Bone or tooth abnormalities •Neurologic abnormalities •Gummas (granulomatous inflammatory response to spirochetes) in the skin or mucous membranes •Other interstitial keratitis A50.31. ICD-10-CM Diagnosis Code A50.31. Late congenital syphilitic interstitial keratitis. Syphilis (acquired) without clinical manifestations, with positive serological reaction and negative spinal fluid test, less than two years after infection 1. INTERSTITIAL KERATITIS BALAJI S 2. Definition Non ulcerative inflammation of corneal stroma without primary involvement of epithelium and endothelium. It is mostly allergic in origin and may be infective also. 3. Causes Congenital syphilis TB Cogan's syndrome Acquired syphilis Trypanosomiasis Leprosy Malaria 4 Go to Interstitial Keratitis for more complete information on this topic. Syphilis in HIV-exposed infants Several studies have demonstrated atypical features of congenial syphilis in infants simultaneously infected with HIV and treponema Syphilis has 3 stages. Primary syphilis has characteristic painless chancres at the site of primary inoculation. Secondary syphilis has symptoms similar to early congenital syphilis but especially a polymorphous rash on palms and soles, lymphadenopathy and fever. If untreated syphilis enters a latent stage and is not contagious during this time

A photograph of a patient with congenital syphilis exhibiting interstitial corneal keratitis, 1966. This patient's congenital syphilitic disease resulted in the onset of interstitial keratitis, an inflammation of the connective tissue structure of the cornea. Syphilis is the most common cause for this condition. Image courtesy CDC/Richard Deitrick The incidence of syphilis continues to rise in the USA and Europe, and it is estimated that around 20% of patients with syphilis in the USA also have HIV infection[2-4]. Ocular involvement may be silent or present as anterior uveitis, choroiditis, interstitial keratitis, retinal vasculitis, retinitis, optic neuritis, dacryoadenitis, or. A boy aged 11 years was diagnosed as suffering from interstitial keratitis; he was found to have congenital syphilis at the age of 2 years and was treated with a total of 15 mega units of penicillin over a period of 18 months, during which time he was clinically normal. 9 years later he developed interstitial keratitis and was treated with atropine and hydrocortisone; 3 serum tests for syphilis..

Syphilis is a sexually transmitted disease caused by bacteria. It infects the genital area, lips, mouth, or anus of both men and women. You usually get syphilis from sexual contact with someone who has it. It can also pass from mother to baby during pregnancy. The early stage of syphilis usually causes a single, small, painless sore Syphilis is associated with the following ocular diseases: interstitial keratitis, episcleritis, scleritis, iritis, iris papules, chorioretinitis, papillitis, retinal vasculitis, and exudative retinal detachment. Examples of ocular manifestations of syphilis are shown in the images below INTERSTITIAL KERATITIS AND CHORIORETINITIS INTERSTITIAL KERATITIS AND CHORIORETINITIS Oksala, Arvo 1952-08-01 00:00:00 Even before Hutchinson's epoch-making discoveries on the causal connection between congenital syphilis and interstitial keratitis it was believed that congenital syphilis might cause many kinds of changes in the eye fundus ICD-9-CM 097.9 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 097.9 should only be used for claims with a date of service on or before September 30, 2015. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes) Interstitial keratitis (IK) is corneal scarring due to chronic inflammation of the corneal stroma. Congenital syphilis is syphilis present in utero and at birth, and occurs when a child is born to a mother with syphilis. Untreated early syphilis infections results in a high risk of poor pregnancy outcomes, including saddle nose, lower.

Interstitial keratitis: MedlinePlus Medical Encyclopedi

The earliest epidemic of syphilis was described in the late 1400s and early 1500s. 1 Syphilis may have been introduced into western Europe in 1493 after Columbus's initial voyage to the Western Hemisphere. 2 Syphilitic involvement of the nervous system was first described in the 1800s. 3 In 1903, syphilis was first transmitted to experimental animals, and in 1905 Schaudinn and Hoffman. Interstitial keratitis is a serious condition in which blood vessels grow into the cornea. Such growth can cause loss of the normal clearness of the cornea. This condition is often caused by infections. Syphilis is the most common cause of interstitial keratitis, but rare causes include: In the United States, most cases of syphilis are. ICD-10-CM Code. A50.31. Billable codes are sufficient justification for admission to an acute care hospital when used a principal diagnosis. A50.31 is a billable ICD code used to specify a diagnosis of late congenital syphilitic interstitial keratitis. A 'billable code' is detailed enough to be used to specify a medical diagnosis Secondary Syphilis in adults Triad Hutchinson Teeth (1 st lower molors) Deafness (8 th Nerve) Interstitial Keratitis Lymphadenopahy Autoimmune Haemolytic anemia Osteochondritis and Metaphysitis Glaucoma Pseudoparalysis of parrot (Painful limbs) Saddle Nose Frontal [mediconotebook.com

Figure 2Core Concepts - Syphilis - Pathogen-Based DiseasesClinical aspects of congenital syphilis with Hutchinson’s