A woman gave bih to a premature baby of 34 weeks. The baby showed bullous lesions all over the body and X-ray shows periosteitis. What should be the next investigation?
VDRL for both mother and baby.It's a classical clinical picture of congenital syphilis. Bullous lesions are rarely seen in adult form of syphilis but are characteristic of congenital form. VDRL is a sensitive test to diagnose congenital syphilis. Manifestations of congenital syphilis can be classified as follows: 1. Early Manifestations (infectious stage): Within first years of life: Bullous/maculopapular rash, vesicles, Rhinitis and snuffles (earliest sign) Hepatosplenomegaly Lymphadenopathy Hematological: Coomb's negative hemolytic anemia, thrombocytopenia Skeletal: Osteochondritis/Metaphysitis/Pseudoparalysis IUGR: failure to thrive Ocular: Congenital glaucoma, chorioretinitis *CNS: Leptomeningitis, hydrocephalous 2. Residual stigmata Hutchison's teeth, mulberry molars Olympian brow Saddle nose Saber shins 3. Late congenital syphilis (non-infectious) shows: Interstitial keratitis 8th nerve deafness Clutton's joints *Asymptomatic neurosyphilis Recurrent ahropathy
VDRL for both mother and baby
ELISA for HIV
PCR for TB
HBsAg for mother