Disease relevance of Syphilis, Congenital

• Diagnosis of congenital syphilis from placental examination: comparison of histopathology, Steiner stain, and polymerase chain reaction for Treponema pallidum DNA [1].
• BACKGROUND: Syphilis remains a major cause of premature birth, fetal and perinatal death, and congenital syphilis in South Africa, despite systematic antenatal screening by rapid plasma reagin and treatment with 2.4 million U of benzathine penicillin G [2].
• A number of epidemics of poliomyelitis between 1914 and 1962 are related to children with congenital syphilis or yaws under treatment with arsenicals or penicillin [3].
• CONCLUSION: Penicillin is the effective treatment of pregnant patients with syphilis and infants with congenital syphilis [4].
• Hydrops fetalis without rhesus or ABO isoimmunisation should always arouse the suspicion of congenital syphilis [5].

High impact information on Syphilis, Congenital

• A fetal IgM response to T. pallidum antigens with apparent molecular masses of 72, 47, 45, 42, 37, 17, and 15 kDa was observed among sera of infants with congenital syphilis [6].
• The resurgence of congenital syphilis: a cocaine-related problem [7].
• Similarly, the incidence of positive RPR/FTA-ABS (11% vs 4.6%) and congenital syphilis (8% vs 2.3%) was significantly (p < 0.01) higher among infants with cocaine-positive results compared with those with cocaine-negative results [7].
• The role of C4 complement component and the nature and potential role of the immature T and B lymphocyte responses in asymptomatic congenital syphilis is discussed [8].
• Centers for Disease Control and Prevention guidelines for congenital syphilis [9].

Chemical compound and disease context of Syphilis, Congenital

• Treatment of asymptomatic congenital syphilis: benzathine versus procaine penicillin G therapy [10].
• Congenital syphilis after maternal treatment with erythromycin [11].
• The relationship between circulating immune complexes and liver involvement was monitored, and the efficacy of steroid therapy as an adjunct in the treatment of congenital syphilis was investigated [12].
• Thirty neonates with clinical congenital syphilis were randomly assigned into two groups: one group received penicillin therapy only, and the other group penicillin and prednisone as an adjunct [12].
• Procaine penicillin was used for the treatment of congenital syphilis [13].

Biological context of Syphilis, Congenital

• Using the Centers for Disease Control and Prevention's congenital syphilis case definition, 36 infants (45%) were classified as probable cases, 42 (53%) were classified as noncases, and 2 (3%) were syphilitic stillbirths [14].
• From 1982 to 1988, the citywide rate of congenital syphilis for all races increased from 1.2 to 5.8 per 1,000 live births, while rates of cocaine dependence discharges increased from 23.3 to 423.3 per 100,000 women of all races during the same period [15].
• Pregnancies associated with congenital syphilis were significantly associated with lack of prenatal care, lack of maternal therapy for syphilis, and a higher rapid plasma reagin titer, but not with a reported history of "crack" or cocaine use, although detection of cocaine in urine samples was more likely with positive syphilis serology [16].

Anatomical context of Syphilis, Congenital

• Comparison of maternal sera, cord blood, and neonatal sera for detecting presumptive congenital syphilis: relationship with maternal treatment [17].
• There were no differences in lymphocyte transformation to phytohaemagglutinin (PHA) and in the CD3, CD4, and CD8 lymphocytes between infants with congenital syphilis and controls [18].
• CONCLUSION--Most live-born infants with congenital syphilis (23 of 35) lacked rash, hepatosplenomegaly, or adenopathy but were identified by laboratory tests (roentgenograms, cerebrospinal fluid VDRL test, conjugated bilirubin determination, or aspartate aminotransferase levels in serum samples) [16].

Gene context of Syphilis, Congenital

• Placental histological features associated with congenital syphilis include the triad of enlarged hypercellular villi, proliferative fetal vascular changes, and acute or chronic villitis [1].
• Acquired and congenital syphilis are both known causes of potentially reversible sensorineural hearing loss [19].
• Three otosclerosis patients who had preimplant radiographs, and one congenital syphilis patient showed classic radiographic signs of their respective diseases [20].
• The syndrome presents systemic and dental manifestations, which are separate although similar to those found in other disease entities, i.e., congenital syphilis, hereditary ectodermal dysplasia [21].
• The antenatal prevention of congenital syphilis in a peri-urban settlement [22].

Analytical, diagnostic and therapeutic context of Syphilis, Congenital

• This study estimated the strength of association between maternal cocaine use and congenital syphilis after adjustment for other factors, especially the use of prenatal care [23].
• The association between congenital syphilis and cocaine/crack use in New York City: a case-control study [24].
• The incidence of positive RPR/FTA-ABS result (10.5% vs 4.4%) and congenital syphilis (7% vs 2.5%) was significantly higher (p < 0.01) among infants with positive results compared with those with negative drug screening results [7].
• Factors responsible for the increase in reported cases of congenital syphilis include poor prenatal care, implementation of new surveillance case definition, failure to perform serological tests, treatment failures with benzathine penicillin, and maternal reinfection [25].
• None of the newborns had clinical evidence of congenital syphilis and their sera lacked IgM reactivity to T. pallidum antigens by immunoblotting [26].

References