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Syphilitic runny nose
Last reviewed: 04.07.2025
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Syphilitic rhinitis of newborns occurs when the fetus is infected with syphilis through the placenta from a sick mother. It occurs 2-3 weeks after birth and can be mistaken for other types of rhinitis of newborns.
Pathological changes are characterized by the appearance of infiltrates and ulcers on the nasal septum and other formations of the internal nose, which lead to the destruction of cartilage and even bone tissue with subsequent deformation of the nose, observed in gummatous syphilis in adults. Microscopically, morphological changes characteristic of stage II-III syphilis are detected.
Symptoms: at the onset of the disease - bilateral obstruction of the nasal passages followed by abundant serous discharge, which then becomes mucopurulent, dirty gray, greenish, hemorrhagic with a putrid odor. Purulent discharge dries and forms abundant greenish-yellow or dirty-brown crusts in the vestibule of the nose, spreading to the adjacent skin of the upper lip. Bleeding cracks form under the crusts, which are a pathognomonic symptom for congenital syphilis of the nose. Subsequently, they form characteristic whitish scars (stria luctica) radiating from the nostrils, which persist for life. Syphilitic rhinitis of a newborn may be accompanied by manifestations of infection at a distance (pemphigus, cutaneous syphilides, severe lesions of internal organs).
The diagnosis is based on the described signs, as well as on serological analysis of the mother's and newborn's blood. Differential diagnostics is very difficult and should be carried out with all the above-described neonatal rhinitis, taking into account the timing of the onset of the disease, the mother's medical history, possible remote complications, and bacteriological and serological studies.
Complications of syphilitic rhinitis. Syphilitic rhinitis of a newborn is often accompanied by adenoiditis, which may be followed by purulent otitis. Sometimes cervical lymphadenitis or even adenophlegmon of the neck occurs, caused by a banal infection. Cicatricial-destructive deformations of the nasal pyramid and formations of the internal nose are also observed.
The prognosis is determined by timely diagnosis and the effectiveness of the treatment undertaken.
Treatment of syphilitic rhinitis. All the methods described above are used locally for other forms of rhinitis in newborns. General treatment is prescribed by a venereologist, and sometimes bismuth preparations are also used.