Acquired syphilis in children: A retrospective study over two‐and‐a‐half decades in a tertiary care center in northern India

Abstract

Background Syphilis causes considerable morbidity not only in adults but also in children. Unfortunately, acquired syphilis in children has not received due attention and remains a relatively ignored field. Methods This was a retrospective study, in which epidemiologic, clinical, and investigational data were analyzed from medical records of all sexually transmitted infection (STI) cases attending the STI clinic of Pt. B. D. Sharma, PGIMS, Rohtak from January 1992 to November 2018. Children of age ≤14 years with acquired syphilis were studied. Results Of 9138 STD cases registered from January 1992 to November 2018, 39 were children with acquired syphilis, of whom 22 were males and 17 were females. The majority were in 12‐14 years age group (22 cases; 56.41%). A history of sexual abuse could be elicited in 10 patients. Three gave a history of voluntary sexual activity. Examination revealed secondary syphilis in 32, latent syphilis in 6 and only one case of primary chancre. Analysis of incidence of pediatric acquired syphilis cases over three‐year intervals during the last 27 years indicated an initial decreasing trend followed by recent slight rise in last 3 years. Conclusion Social inhibitions and reluctance to report child sexual abuse may have led to an underestimate of actual prevalence. The prevalence in the 12‐ to 14‐year age group may indicate emerging trends of promiscuous sexual behavior. The recent rising trend in occurrence of childhood acquired syphilis may mirror the recent resurgence of adult syphilis.

A 9-Month-old Infant with Non-healing Oral Ulcers

“…3 Sexual abuse is also another consideration for children with syphilis. 4 Acquired syphilis by nonsexual contact is very rare in the postantibiotic era, although it was common in the early 1900s. 5…”

“…8 In the postantibiotic era, there are few case reports in the medical literature regarding nonsexual syphilis transmission in children, and most were associated with feeding children premasticated foods. 4,9 Moscatelli et al 9 from Argentina recently published the first nonsexually acquired syphilis study in the 21st century. In their retrospective study, they reported 24 patients with nonsexually acquired syphilis with a median age of 4.2 years and the youngest and the oldest being 1 and 17 years of age, respectively.…”

“…3 Sexual abuse is also another consideration for children with syphilis. 4 Acquired syphilis by nonsexual contact is very rare in the postantibiotic era, although it was common in the early 1900s. 5 In this case, we could not totally rule out congenital syphilis since the mother did not have a syphilis test around the time of delivery.…”