[Question #2315] Congenital syphilis - How to proceed

46 months ago

Hello again,

First of all, sorry if my questions are outside of your area of expertise. Second, I was not completely honest in my first post. Yes, It all began with a drunken risky relation with a CSW; but I was so unfortunate as to have at the same time an unexplainable candida infection in the tongue. The two things together made me don’t believe my negative HIV tests. Incredibly, after some time despairing, I began to drink and visit CSWs – about 10 times. Every time I did I tested for HIV.

Now I’m sure the astronomically unlikely has happened to me and I infected my child. To recap, at 5 months mysterious febrile illness for two months; since 14 months until now, serous, recurrent otitis; at 22 months, febrile illness with hepatosplenomegaly. Now we see he had a very very abnormal teeth and that his forehead is pretty prominent. He got a swollen neck node one month ago; two days ago, he got a rash in his genitals and around his anus; and also about five purple lesions –behind its ears and in the chest. I went to his doctor; she is intrigued but not worried.

I had three treponemal tests in the blood bank about 2 years after the infection and after two different weekly rounds of 3 grams of amoxicillin daily; my wife had two RPR negative tests in her pregnancy and here all tests offered by private labs are RPR or VDRL. She is not eligible to give blood. So, the only option is to have my child tested. I’d like you to advice me on how to proceed. For example, Should I go to ER and tell directly my suspicions? Or, go to ER and just show them all the symptoms and let the doctors decide?

Edward W. Hook M.D.

46 months ago

I'm sorry to see that you continue to be plagued by guilt related to your pat infidelities irrespective of their basis. My sense is that you have linked a variety of issues related to your child's health to your past behavior, blaming yourself and having convinced that you acquired an STI of some sort which is leading to health problems for your child despite negative tests. To address this you now want to have your child tested, for both syphilis and HIV I imagine. Your concerns and their recurring nature lead me to suspect that these concerns that you will not be able to address without help. It is not clear whether you have told your wife about your infidelities or not or, if you have not, whether you feel you can. Irrespective of whether you have told her or not, my advice is the same. You need help on this matter and not from an Infectious Diseases expert. My advice, and I think it is the most important advice I can provide, is that you need to seek professional help from a counselor or mental health professional to address your guilt and its consequences as it does not appear that your own efforts are succeeding.

As for testing your child, going to an ER where you will see a health care provider who does not know you, your wife or your child will not help. If testing is warranted, and I am not convinced that it is, I would suggest that you take your child to your pediatrician and ask for the testing. In unusual and uncommon illnesses (I do not know whether your child has these or not) context is important and thus having your pediatrician, who knows your child, perform the testing and consider the results in context is best, if testing is needed at all. EWH

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46 months ago

Thanks for your answer,

but really, this is not a guilt related question. My mistakes happened a long time ago ( +5 years ) and they were all but forgotten.

Until symptomps began to make me suspicious, I was very happy and completely at peace with myself.

Also, I'm not worring about HIV. I know for sure he doesn’t have it: I’m negative and my wife is negative. If I was worried about HIV,

I would go and get a test and , if negative, I would stop worring. Likewise, had I not taken the antibiotics,

I would go and take a treponemal syphilis test and, if negative, I would worry no further about it. Really.

The thing is that no matter where I look, all points to this awful congenital syphilis and, though remote, it's a real possibility.

Yes, it's true, I'm not a doctor so I can be wrong. That's my only hope. But I'm convinced the worst has happened; I don't really see any other realistic possiblity to explain all my son symptoms.

Thanks for your time. I'm going to give myself a few hours to decide how to proceed.

I'll try to let you informed.