The clinical signs of congenital syphilis in neonates include nonimmune hydrops, jaundice, hepatosplenomegaly, rhinitis, skin rash, and pseudoparalysis
He also presented with pseudoparalysis
of his left shoulder due to severe pain.
The osteochondritis is painful, resulting in the refusal to move the involved limb (pseudoparalysis
of Parrot) [5, 7, 8].
On examination she was febrile and had a warm, swollen right shoulder and elbow with associated pseudoparalysis
of both joints.
Therefore, this clinical situation is called "Parrot's pseudoparalysis
Physical examination at that time showed pseudoparalysis
as exhibited by active forward flexion and abduction at 60-65[degrees] and superior-posterior shoulder subluxations (Table 1).
Another 3(15%) clavicle fracture cases were associated with pseudoparalysis
in the ipsilateral upper limb.
([dagger]) Signs and symptoms of CS in an infant or a child aged <2 years included condyloma lata, snuffles, syphilitic rash, hepatosplenomegaly, jaundice/hepatitis, pseudoparalysis
, or edema (nephrotic syndrome, malnutrition, or both).
Reverse shoulder arthroplasty combined with a modified latissimus dorsi and teres major tendon transfer for shoulder pseudoparalysis
associated with dropping arm.
Like in the acquired secondary syphilis, the patient can present lymphadenopathy, hepatosplenomegaly, osteochondritis (epiphisitis), with pain on motion--hence the refusal to move (Parrot's pseudoparalysis
) periostitis, nephrotic syndrome, acute glomerulonephritis, and such neurological manifestations as: meningitis, meningoencephalitis, obstructive hydrocephalus, cranial nerve palsies, cerebrovascular accidents, choroiditis, etc.
The latissimus dorsi transfer has been used for over 20 years and is a good option if there is no active external rotation (pseudoparalysis
) (Gerber et al 1988, Warner & Parsons 2001).
Changes in the gums are most noticeable after teeth have erupted and are manifested as bluish purple, spongy swellings of the mucous membrane, especially over the upper incisors.1 Extracutaneous findings include scorbutic rosary, fractures, pain and tenderness of bones, pseudoparalysis
, and normochromic normocytic anemia.1,7 In advanced cases, hypotension and high-output cardiac failure may be seen.1 Neuropsychiatric manifestations may be seen and include depression, lethargy, Irritability, emotional changes, and convulsions.2 Scurvy can occur at any age; the incidence of scurvy peaks in children aged 6-12 months as well as in elderly populations.1