Congenital Syphilis and the Prozone Phenomenon

Introduction: Congenital Syphilis (CS) occurs through the transplacental transmission of Treponema pallidum in inadequately treated or non-treated pregnant women, and is capable of severe consequences such as miscarriage, preterm birth, congenital disease and/or neonatal death. CS has been showing an increasing incidence worldwide, with an increase of 208% from 2009 to 2015 in Brazil. Case report: 2-month old infant receives care in emergency service due to edema of right lower limb with pain in mobilization. X-ray with osteolytic lesion in distal fibula. Infant was sent to the Pediatrics Oncology clinic. Perinatal data: 7 prenatal appointments, negative serology at 10 and 30 weeks of gestation. End of pregnancy tests were not examined and tests for mother’s hospital admission were not requested. Mother undergone elective cesarean section at 38 weeks without complications. During the pediatric oncologist appointment, patient showed erythematous-squamous lesions in neck and other scar-like lesions in upper body. A new X-ray of lower limbs showed lesions in right fibula with periosteal reaction associated with aggressive osteolytic lesion compromising distal diaphysis, with cortical bone rupture and signs of pathological fracture, suggestive of eosinophilic granuloma. She was hospitalized for a lesion biopsy. Laboratory tests: hematocrit: 23.1 / hemoglobin 7.7 / leukocytes 10,130 (without left deviation) / platelets 638,000 / Negative Cytomegalovirus IgG and IgM and Toxoplasmosis IgG and IgM / VDRL 1:128. Congenital syphilis diagnosis with skin lesions, bone alterations and anemia. Lumbar puncture: glucose 55 / total proteins 26 / VDRL non reagent / 13 leukocytes (8% neutrophils; 84% monomorphonuclear; 8% macrophages) and 160 erythrocytes / negative VDRL and culture. X-ray of other long bones, ophthalmological evaluation and abdominal ultrasound without alterations. Patient was hospitalized for 14 days for treatment with Ceftriaxone 100mg/kg/day, due to the lack of Crystalline Penicillin in the hospital. She is now under outpatient follow-up. Discussion: CS is responsible for high rates of morbidity and mortality. The ongoing increase of cases of this pathology reflects a severe health issue and indicates failures in policies for the prevention of sexually transmitted diseases, with inadequate follow-up of prenatal and maternity protocols.

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Epidemiological Characterization of the Infection by Treponema Pallidum in Pregnant Women in Beira City, Sofala, Mozambique

Annals of Immunology & Immunotherapy ◽

10.23880/aii-16000123 ◽

2020 ◽

Vol 2 (2) ◽

Author(s):

Nchowela Guido

Keyword(s):

Pregnant Women ◽

Congenital Syphilis ◽

Health Centre ◽

Treponema Pallidum ◽

Timely Manner ◽

Pregnancy And Childbirth ◽

Epidemiological Characterization ◽

Active Syphilis ◽

Structured Questionnaire

Introduction: Syphilis is one of several diseases that can be transmitted during pregnancy and childbirth, which can lead to complications during pregnancy and in the newborn. This is especially so when the pregnant woman is not diagnosed or treated properly and in a timely manner. Methodology: Data from 262 pregnant women prospectively included, aged 18-41years, attended at the Ponta Gêa Health Centre for antenatal clinics has been analyzed from January to September of 2016. In the prospective study, a rapid treponemal and a non-treponemal test were performed. A structured questionnaire was used to collect socio demographic and clinical variables, which was developed from the literature review. Results: The prevalence of active syphilis was 11.8%; the majority of reactive pregnant women were aged 18-25years (55.4%), (61.3%) of pregnant women were treated with doses below those recommended; only a small number of the partners were treated successfully. The highest seroprevalence of syphilis was found in housewives (77%), in those who attended primary education (71.6%) in those who had a monthly income of 1000- 3000 MZN (70.3%), in those with two or more pregnancies (55.7%) and living with someone has husband and wife (63.5%). The syphilis/HIV co-infection rate was high. Conclusion: According to the results obtained in this study, urgent measures are needed to assess the problems encountered and to improve the screening approach, treatment and monitoring of syphilis during pregnancy in order to prevent the cases of congenital syphilis.

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Early postnatal diagnosis of congenital syphilis: contribution of a comparative Western Blot method

10.26226/morressier.56d5ba31d462b80296c967a7 ◽

2016 ◽

Author(s):

Antonella Marangoni

Keyword(s):

Western Blot ◽

Congenital Syphilis ◽

Western Blot Method ◽

Postnatal Diagnosis

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Congenital Syphilis Retrospective Survey Study

Case Medical Research ◽

10.31525/ct1-nct04137601 ◽

2019 ◽

Author(s):

Keyword(s):

Congenital Syphilis ◽

Survey Study ◽

Retrospective Survey

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Corroboration of the Prozone Phenomenon in IgG4-Related Disease: Comment on the Article by Khosroshahi et al

Arthritis & Rheumatology ◽

10.1002/art.38663 ◽

2014 ◽

Vol 66 (7) ◽

pp. 1963-1964 ◽

Cited By ~ 2

Author(s):

Nadine Urquhart ◽

Andre Mattman

Keyword(s):

Related Disease ◽

Igg4 Related Disease ◽

Prozone Phenomenon

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Outcomes of infants born to pregnant women with syphilis: a nationwide study in Korea

BMC Pediatrics ◽

10.1186/s12887-021-02502-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Joohee Lim ◽

So Jin Yoon ◽

Jeong Eun Shin ◽

Jung Ho Han ◽

Soon Min Lee ◽

...

Keyword(s):

Mental Retardation ◽

Renal Disease ◽

Hearing Impairment ◽

Congenital Syphilis ◽

Day Treatment ◽

National Level ◽

International Classification Of Diseases ◽

Nationwide Study ◽

Screening Programs

Abstract Background Despite the expansion of antenatal syphilis screening programs, congenital syphilis (CS) remains a concern. Purpose This study aimed to analyze the manifestation and progress of CS, including treatment and follow-up, based on a nationwide study. Methods From the Korean National Health Insurance Service database, a total of 548 infants were examined for CS during their first year of life from 2013 to 2018. Neurosyphilis and complications were investigated using the International Classification of Diseases-10 codes. Results The birth rate of infants from mothers with syphilis was 2.8 per 10,000 live births for 5 years, which is not indicative of a decreasing trend. Overall, 148 infants were proven or highly probable or possible of having CS with treatment for 10 days; 66 infants were possible or less likely of having CS with only 1-day treatment. Jaundice (56 %) was common, followed by hearing impairment (14 %), renal disease (8 %), and mental retardation (8 %). Fourteen cases of neurosyphilis occurred. Infants with complications, including mental retardation, eye involvement, hearing impairment, or renal disease, were significantly associated with neurosyphilis (OR 8.49, P < 0.0001). Of 250 patients who received treatment, 92.8 % were treated with one medication: benzathine penicillin was used in 73 % of patients. Only four patients were re-treated due to treatment failure. In addition to the treponemal test, fluorescent treponemal antibody-absorption was the most utilized tool for diagnosis and follow-up. Conclusions Establishing standardized guidelines for the evaluation of CS, as well as the establishment of treatment regimens and follow up-plans for the disease, at a national level would help improve maternal and neonatal care and facilitate the eradication of CS in Korea.

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