<s>[INST] context: (Congenital syphilis) (1265- Nelson 18th)HUTCHINSON TEETH - which arc the peg or barrel shaped upper central incisors that erupt during the 6th year of life: abnormal enamel, which results in a notch along the biting surface, seen in Late manifestation of congenital syphilisEarly manifestations of congenital syphilis* Approximately 66% of infected ifants are asymptomatic* Hepatosplenomegaly jaundice, elevated liver enzymes are common* Lymphadenopathy to be diffuse, shotty nodes may persist* Coombs negative hemolytic anemia, Thrombocytopenia* Osteochondritis, periostitis* Limbs are held immobile due to excruciating pain (pseudo paralysis of parrot)*** Mucous patches, rhinitis (snuffles)* and condylomatous lesions are highly characteristic* CNS abnormalities, failure to thrive, chorioretinitis, nephritis and nephritic syndrome* Renal involvement include - hypertension, hematuria, proteinuria, hypoproteinemia, hypercholesterolemia, and hypocomplementemia* Less common clinical manifestations - gastroenteritis, peritonitis, pancreatitis, pneumonia, eye involvement glaucoma and chorioretinitis) nonimmune hydrops and testicular masses.Late manifestations of congenital syphilis* Frontal bossing, a bony prominence of the forehead (Olympian brow), unilateral or bilateral thickening of the sternoclavicular third of clavicle (Clavicular or Higoumenaki'sign)* Saber shins, scaphoid scapula, Hutchinson teeth, mulbeny molars* Saddle nose, Rhagedes, Juvenile paresis - Juvenile tables* Hypersensitivity phenomenon - interstitial keratitis, blindness less common ocular manifestations include - choroiditis, retinitis, vascular occlusion and optic atrophy, eighth nerve deafness* Clutton joint - U/L or B/L synovitis usually in the knee painless, soft tissue gammas, paroxysmal cold hemoglobinuria (rare)Hunterian chancre single painless, regular indurated reddish brown plaque seen in primary syphilis* Congenital varicella syndrome is characteristically associated with limb reduction defects and scarring of skin* Classical Tetrad of congenital Toxoplasmosis* Hydrocephalus or Microcephaly*** Chorioretinitis* Convulsions (seizures)* Cerebral calcifcations*RUBELLA - is a teratogenic virus* can be transmitted from fetus to mother. The rate of transmission and congenital defects maximum in first trimester infections (hearing loss) * Under eradication of congenital rubella syndrome programme the first priorty group of rubella vaccination is- All non pregnant women of age 15 to 34 years*** Most common congenital defects are deafness, cardiac malformations and cataractsOther resulting from defects include - glaucoma, retinopathy microcephalus, cerebral palsy, IUGR, hepatosplenomegaly mental and motor retardation"Chancre- redux" is a clinical feature of early relapsing syphilis at the site of the healed lesionTerm "Viable not cultivable" (VNC) is used for T.pallidum. M. leprae [/INST] question: Hutchinson teeth are seen in | options: A: Toxoplasma B: Congenital syphilis C: Rubella D: CMV- nfections | answer: B </s>