Examination of amniotic fluid in diagnosing congenital syphilis with fetal death

Wendel, George D.; Maberry, Mark C.; Christmas, James T.; Goldberg, Martin; Norgard, Michael V.

doi:10.1016/0020-7292(90)90395-2

Cited by 15 publications

(16 citation statements)

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“…Dark-field microscopy. Amniotic fluids were examined by dark-field microscopy for the presumptive identification of T. pallidum by typical morphology and motility (17,25,45,46). Ten microliters of each sample was placed on an acid-washed microscope slide with a coverslip and examined for 10 to 30 min at x 400 magnification and under oil immersion (x 900).…”

Section: Methodsmentioning

confidence: 99%

Use of polymerase chain reaction and rabbit infectivity testing to detect Treponema pallidum in amniotic fluid, fetal and neonatal sera, and cerebrospinal fluid

et al. 1991

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The diagnosis of congenital syphilis continues to pose a difficult clinical challenge. Because the serodiagnosis of congenital syphilis has significant limitations, the direct detection of Treponema pallidum in suspect neonatal tissues or body fluids represents a desirable alternate diagnostic strategy. We developed and applied the polymerase chain reaction (PCR) for the detection of T. pallidum in clinical materials relevant to the diagnosis of congenital syphilis but which typically contain factors inhibitory for the PCR. Four methods of specimen processing were examined to circumvent PCR inhibition; clinical materials included amniotic fluids, neonatal sera, and neonatal cerebrospinal fluids. The PCR was 100% specific for T. pallidum compared with the sensitive rabbit infectivity test (RIT) for all clinical materials tested. For amniotic fluids, the PCR was 100% sensitive when correlated with the RIT but had a lesser sensitivity when applied to sera or cerebrospinal fluids, which typically contain few treponemes. The combined sensitivity of the PCR for all clinical samples was 78%. Positive PCR results also were obtained among some clinical specimens for which RIT was not performed; these results correlated well with either stigmata or risk factors for congenital syphilis. The combined results suggest that the PCR can be a useful adjunct to the diagnosis and clinical management of congenital syphilis and that it will provide a valuable tool for investigations of the pathogenesis of the disorder.

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Section: Methodsmentioning

confidence: 99%

Use of polymerase chain reaction and rabbit infectivity testing to detect Treponema pallidum in amniotic fluid, fetal and neonatal sera, and cerebrospinal fluid

et al. 1991

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“…Congenital syphilis. Untreated syphilis can profoundly affect pregnancy outcome, resulting in spontaneous abortion, stillbirth, premature delivery, or perinatal death (103,162,352,353). Prematurity and low birth weight have been reported for 10 to 40% of infants born to untreated mothers (184,213).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features

1999

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SUMMARY Syphilis is a chronic disease with a waxing and waning course, the manifestations of which have been described for centuries. It occurs worldwide, and the incidence varies significantly with geographic location. Transmission is mainly by sexual contact. The causative organism, Treponema pallidum, was first described in 1905, but because of the inability to culture the organism and the limitations of direct microscopy, serologic testing is the mainstay of laboratory diagnosis. The disease has been arbitrarily divided into several stages. The primary stage is defined by a chancre at the site of inoculation. The secondary stage is characterized by a polymorphic rash, lymphadenopathy, and other systemic manifestations. A variable asymptomatic latent period follows, which for epidemiologic purposes is divided into early (<1 year) and late (>1 year) stages. The early stages (primary, secondary, and early latent) are potentially infectious. The tertiary stage is the most destructive and is marked by cardiovascular and neurologic sequelae and gummatous involvement of any organ system. Congenital infection may result in protean early or late manifestations. Unlike many other bacteria causing infectious diseases, the organism remains sensitive to penicillin, and this remains the mainstay of therapy.

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“…16 Pemeriksaan mikroskop lapangan pandang gelap, selain untuk melihat morfologi bakteri, dapat juga melihat pergerakannya yang khas. 17 Pada pemeriksaan radiologi dapat dijumpai perubahan metafisis tulang panjang.…”

Section: Pemeriksaan Penunjangunclassified

Diagnosis dan Tata Laksana Sifilis Kongenital

Siagian¹,

Rinawati²

2016

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Smengenai mata, kulit, tulang , visera, susunan saraf pusat, dan sistem kardiovaskular.3 Sifilis kongenital terjadi pada bayi yang ditularkan ibunya yang menderita sifilis. Bila tidak diobati dengan baik, infeksi dapat mengenai berbagai organ janin dan dapat mengakibatkan kematian. 4 Sifilis kongenital merupakan penyakit yang jarang dilaporkan. Di Amerika Serikat tahun 1997, didapatkan 3,2 kasus baru per 100.000 populasi.2 Di RSUPN Cipto Mangunkusumo, sejak tahun 1995 tidak didapatkan laporan mengenai kasus ini. Tujuan laporan kasus ini adalah untuk mengingatkan kembali upaya diagnostik dan tata laksana pasien dengan sifilis kongenital. KasusSeorang bayi perempuan, lahir di kamar bersalin Bagian Kebidanan dan Kandungan RSCM dari ibu ifilis pertama kali ditemukan di Eropa pada akhir abad ke-15 1 dan pada tahun 1905, Schaundinn dan Hoffman menemukan penyebab penyakit ini yaitu Treponema pallidum.2 Penyakit sifilis didapat ditularkan (acquired) melalui kontak seksual. Sifilis primer ditandai dengan adanya luka yang tidak nyeri, mengeras, dan sembuh dalam 7-10 hari. Sifilis sekunder ditandai dengan kelainan pada kulit dan membran mukosa yang terjadi selama 4-6 minggu. Jika berlangsung lama, lesi pada sifilis tertier dapat Seorang bayi perempuan yang menderita sebagai sifilis kongenital dilahirkan oleh ibu dengan diagnosis sifilis stadium II yang tidak mendapat pengobatan. Pada umumnya didapatkan hepatosplenomegali, ikterus, kelainan kulit, pseudoparalisis, anemia, trombositopenia maupun monositosis, pada pemeriksaan fisik maupun laboratorium namun, manifestasi klinis tersebut tidak ditemukan pada kasus ini. Hal ini sesuai dengan kepustakaan yang menyatakan bahwa 50% bayi dengan sifilis kongenital asimtomatik. Pemeriksaan mikroskopik lapangan pandang gelap tidak dilakukan karena tidak didapatkan bahan pada bayi berupa sekret hidung maupun serum dari lesi kulit. Pemeriksaan radiologi didapatkan gambaran radio luser di metafisis tulang femur kanan dan kiri disertai penebalan korteks, penebalan korteks juga tampak di humerus kanan; kelainan ini sesuai dengan sifilis kongenital. Pasien ini diobati dengan penisilin prokain 75 000 U/kali intra muskular satu kali sehari selama sepuluh hari. Pemantauan secara klinis dan pemeriksaan serologis perlu dilakukan secara berkala. Pada usia 51 hari, tidak didapatkan kelainan. Keadaan umum baik, didapatkan kenaikan berat badan 27 gram/ hari, dan penambahan tinggi badan 8 sentimeter dalam 51 hari. Pemantauan selanjutnya yang diperlukan adalah pemeriksaan klinis setiap bulan sampai bulan ke-3, kemudian bulan ke-6 dan ke-12 sesudah pengobatan dan pemantauan serologi VDRL direncanakan pada bulan ke-3 dan ke-6 untuk menilai keberhasilan terapi yang diberikan. Dengan terapi yang adekuat diharapkan komplikasi sifilis kongenital dini dan lanjut tidak terjadi.Kata kunci: sifilis kongenital, kandiloma akuminatum VDRL, TPHA

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Examination of amniotic fluid in diagnosing congenital syphilis with fetal death

Cited by 15 publications

References 0 publications

Use of polymerase chain reaction and rabbit infectivity testing to detect Treponema pallidum in amniotic fluid, fetal and neonatal sera, and cerebrospinal fluid

Use of polymerase chain reaction and rabbit infectivity testing to detect Treponema pallidum in amniotic fluid, fetal and neonatal sera, and cerebrospinal fluid

Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features

Diagnosis dan Tata Laksana Sifilis Kongenital

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