2022 Volume 58 Issue 5 Pages 832-837
The patient was a 0-day-old male infant born at 34 weeks of gestation by spontaneous cephalic delivery at a previous maternity hospital. Maternal syphilis infection was found by blood tests at the time of admission. Thus, the patient was suspected of developing congenital syphilis and transferred to our hospital for detailed examination and treatment. Physical examination showed deep wrinkles and exfoliation of fragile skin on the face and epidermal exfoliation and hepatosplenomegaly on the body. A blood test showed a positive syphilis serum reaction and a specific antibody. A diagnosis of congenital syphilis was made, and penicillin G administration was started. Since abnormalities in D-Bil, AST, ALT, and γGTP levels persisted, direct cholangiography and liver biopsy were performed at 86 days of age, leading to a diagnosis of paucity of intrahepatic bile ducts. The blood test data values improved after peaking at 98 days of age, and the patient was discharged at 116 days of age. There are cases in which jaundice and hepatobiliary enzyme levels persist even after antibiotic treatment and liver protection therapy are given to children diagnosed with congenital syphilis. In this case, paucity of intrahepatic bile ducts may be secondary, so cholangiography and liver biopsy are required to identify other diseases.
