Parrot’s pseudoparalysis in congenital syphilis

Authors

  • Serene Ahmad University of North Carolina School of Medicine

DOI:

https://doi.org/10.47265/cjim.v2i1.2671

Keywords:

congenital disease, infectious disease, microbiology

Abstract

Introduction: Congenital syphilis is an intrauterine infection transmitted by the spirochete Treponema pallidum, and it is the most common congenital infection in the world. Cases of congenital syphilis continue to rise in the United States, and prompt clinical diagnosis of those cases that escape prenatal screening is critical given the wide availability of treatment and prevention of long-term sequela when treatment is provided.   Case Presentation: Here we report an infant who presented with irritability and apparent paralysis of the right upper extremity, consistent with Parrot’s pseudoparalysis, a classic physical exam finding in congenital syphilis. The infant was treated with intravenous penicillin G for 10 days. In the following months, the infant’s symptoms improved – she was able to move all limbs comfortably and the pseudoparalysis completely subsided. Cranial and eye exams were normal. Her liver function tests normalized, and repeat non-treponemal antibodies fell at a slow rate over several months. Her growth and development were appropriate for age.   Conclusions: This case illustrates the importance of recognizing pseudoparalysis of Parrot and of considering congenital syphilis in an infant with bone pain or apparent paresis. Prior reports of pseudoparalysis of Parrot are reviewed.

References

Cooper JM, Sánchez PJ. Congenital syphilis. Seminars in perinatology. 2018;42(3).

Kocher MS, Caniza M. Parrot pseudoparalysis of the upper extremities. A case report. J Bone Joint Surg Am. 1996;78(2):284–287.

Rac MW, Revell PA, Eppes CS. Syphilis during pregnancy: a preventable threat to maternal-fetal health. Am J Obstet Gynecol. 2017;216(4):352–363.

Kimball A, Torrone E, Miele K. Missed Opportunities for Prevention of Congenital Syphilis - United States. MMWR Morb Mortal Wkly Rep. 2018;69:661–665.

Morrisroe E, Farzana SF, Mckinnon J. Congenital syphilis in a 4-month-old infant with limb weakness. BMJ Case Rep. 2021;14(2).

Arnold SR, El FJ. Congenital syphilis: A guide to diagnosis and management. Paediatr Child Health. 2000;5(8):463–469.

Parrot J. Sur ene pseudo-paralysie. Arch Physiol;4:1871–1872.

Rothner AD, Klein N. Parrot’s Pseudoparalysis. Revisited Pediatrics. 1975;56(4):604–605.

Rasool MN, Govender S. The skeletal manifestations of congenital syphilis. A review of 197 cases. J Bone Joint Surg Br. 1989;71(5):752-755.

Pereira AA, Castro SM, Venturini RR, et al. Pseudoparalysis of Parrot: A Diagnostic Aid in Congenital Syphilis. J Pediatr. 2017;190:282–282.

Butler T. The JarischHerxheimer Reaction After Antibiotic Treatment of Spirochetal Infections: A Review of Recent Cases and Our Understanding of Pathogenesis. Am J Trop Med Hyg. 2017;96(1):46–52.

Armangil D, Canpolat FE, Yifiit S, et al. Early congenital syphilis with isolated bone involvement: a case report. The Turkish Journal of Pediatrics. 2009;51(2):169–171.

Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines. MMWR Recomm Rep. 2015;64(33):1–137

Additional Files

Published

2022-12-19

How to Cite

Ahmad, S. (2022). Parrot’s pseudoparalysis in congenital syphilis. Carolina Journal of Interdisciplinary Medicine, 2(1). https://doi.org/10.47265/cjim.v2i1.2671