Pseudoparalysis paradox: Think of ‘SCORTCH’

Key Points

Diagnosis of congenital syphilis can be difficult due to many infants being asymptomatic at birth, complicating identification.
In this case, excessive crying without radiographic changes was misinterpreted as pseudoparalysis, highlighting diagnostic challenges.
Assessment using the SCORTCH profile confirmed congenital syphilis, leading to targeted treatment and improved outcomes.
Effective management with ceftriaxone resulted in positive development for the neonate at 1 year, underscoring therapeutic options.

Abstract

There is recent resurgence in incidence of congenital syphilis (CS) in developing and developed countries. Diagnosis of CS can be difficult because approximately two-thirds infants affected are asymptomatic at birth. Pseudoparalysis due to bony pain is often not a sign but symptom, obvious not only to healthcare providers but also parents. We report a case of CS, observed to have excessive crying episodes on handling with no obvious changes on radiograph. Evaluation with 'SCORTCH' profile clinched the diagnosis. Neonate was treated with ceftriaxone due to non-availability of crystalline or procaine penicillin with good outcome at 1year of age.

Pseudoparalysis paradox: Think of ‘SCORTCH’

Key Points

Abstract

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