Friday Pop Quiz #392

The correct answer is D. Pseudoparalysis.

This patient’s mother has an exam consistent with secondary syphilis. Syphilis, part of the “other” category in the TORCHes infection, can be passed down from mother to fetus during pregnancy. Of all the listed complications, pseudoparalysis is associated with congenital syphilis. Pseudoparalysis of Parrot, named after Jules Marie Parrot, is a manifestation of early congenital syphilis where infants are unwilling to move their upper extremities due to immense pain from syphilis affecting the bone and joints. As syphilis is on the rise in the US, it is important to know the many signs of congenital syphilis.

Natal teeth are associated with pachonychia congenita, not congenital syphilis. Hutchinson teeth and mulberry molars are the dental findings associated with late congenital syphilis.

Supernumerary vertebrae with extra ribs is associated with incontinentia pigmenti. Instead, unilateral thickening of the inner ⅓ of the clavicle, “Higoumenakis sign,” is seen in late congenital syphilis.

Hydrops fetalis is most often associated with congenital Parvovirus B19 infection.
Reference: Li Y, Connelly SV. Pseudoparalysis of parrot – Re-emergence of the great mimicker. Am J Emerg Med. 2021;48:378.e1-378.e2. doi:10.1016/j.ajem.2021.04.038
Pereira AA, Castro SM, Venturini RR, César FO, Fortes PM, Costa PS. Pseudoparalysis of Parrot: A Diagnostic Aid in Congenital Syphilis. J Pediatr. 2017;190:282. doi:10.1016/j.jpeds.2017.07.048