Key result
VA-ECMO enables survival to discharge in a neonate with congenital syphilis and refractory shock.
Why the study?
Congenital syphilis is a severe infection with a rising global incidence and potentially life-threatening neonatal outcomes.
Case Report (n=1)
No
This case report highlights venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a viable rescue therapy for refractory neonatal shock and severe pulmonary hypertension caused by congenital syphilis.
Answers are grounded in this paper and cite their sources.
May support VA-ECMO consideration in refractory congenital syphilis shock; leaves open efficacy and safety in larger cohorts.
Congenital syphilis (CS) is a severe infection with a rising global incidence and potentially life-threatening neonatal outcomes. We present a late preterm infant exhibiting respiratory distress, hepatosplenomegaly, and systemic inflammation. Diagnosed with congenital syphilis at 12 hours of life, targeted antimicrobial was promptly initiated. Despite maximal medical management, her clinical course rapidly deteriorated into refractory shock, severe pulmonary hypertension, and multiple organ dysfunction. This necessitated venoarterial extracorporeal membrane oxygenation (VA-ECMO). The infant underwent 7 days of VA-ECMO, 19 days of renal replacement therapy and 23 days of mechanical ventilation before successfully discharging with multidisciplinary follow-up. This case underscores the devastating potential of re-emerging congenital syphilis. It also highlights VA-ECMO as a viable rescue therapy for refractory neonatal shock, emphasizing the critical need for early referral to specialized centers.
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Guillier et al. (2026) conducted a case report in Congenital syphilis with refractory shock, severe pulmonary hypertension, and multiple organ dysfunction (n=1). Venoarterial extracorporeal membrane oxygenation (VA-ECMO), targeted antimicrobial therapy, renal replacement therapy, and mechanical ventilation was evaluated on Survival to hospital discharge. VA-ECMO for 7 days alongside 19 days of renal replacement therapy and 23 days of mechanical ventilation enabled survival to discharge in a neonate with congenital syphilis and refractory shock.
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