Neurosyphilis in Brazilian newborns: a health problem that could be avoided

Ribeiro, Anny Danyelly da Costa; Dan, Cristiane de Sá; Santos, Andréa da Silva; Croda, Júlio; Simionatto, Simone

doi:10.1590/s1678-9946202062082

Cited by 9 publications

(5 citation statements)

References 18 publications

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“…In our study, CSF abnormalities, including reactive VDRL or elevated WBC count or protein levels, were detected in 31.6% (18/57) of infants with CS, while none of these infants had neurological symptoms. The diagnosis of congenital neurosyphilis is difficult to establish since the majority of infants with CS do not manifest any abnormalities on neurologic examination ( 31 ). Currently, central nervous system invasion by T. pallidum is usually inferred from CSF abnormalities, such as reactive VDRL, pleocytosis, and elevated protein levels ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

The Clinical Characteristics and Serological Outcomes of Infants With Confirmed or Suspected Congenital Syphilis in Shanghai, China: A Hospital-Based Study

et al. 2022

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BackgroundCongenital syphilis (CS) is the infection of an infant or fetus with Treponema pallidum. The aim of this study was to investigate the clinical features and outcomes of serology reversion in infants diagnosed with confirmed or suspected congenital syphilis (CS).MethodsInfants admitted to the neonatal department of Children's Hospital of Fudan University from 2013 to 2016 who met the case definition of CS or suspected CS were included in this study. Follow-up was performed in an outpatient clinic until reversion to non-reactivity of both toluidine red unheated serum test (TRUST) and Treponemal pallidum particle agglutination (TPPA). Follow-up data were collected until up to the end of 2019, when the last infant with CS reached 3 years of age.ResultsIn total, 682 infants were enrolled in this study, including 63 in the CS group and 619 in the suspected CS group. Forty-seven infants (74.6%) in the CS group had symptoms, and 57 (90.5%) had abnormal laboratory and/or long bone X-ray findings. By 6 months of age, TRUST results were negative in 53.3% of the infants with CS and in 100% of the infants with suspected CS. All the infants in the CS group returned to TRUST non-reactivity by 18 months of age. The TPPA results at 18 months of age showed that only 10.0% (3/30) of the patients in the CS group returned to non-reactivity, while a 99.6% (548/550) non-reactivity rate was observed in the suspected CS group. All the infants in the CS group returned to 19S-IgM-TPPA non-reactivity by 6 months of age.ConclusionsAlthough CS is an burdensome disease that may cause fetal and neonatal death, CS responds well to treatment when diagnosed and treated promptly, even when symptoms or lab/X-ray findings are present at birth.

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Section: Discussionmentioning

confidence: 99%

The Clinical Characteristics and Serological Outcomes of Infants With Confirmed or Suspected Congenital Syphilis in Shanghai, China: A Hospital-Based Study

et al. 2022

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“…A study conducted from July 2017 to December 2017, with parturients admitted to the maternity ward of the University Hospital, in Dourados, Brazil, involving 63 pregnant women diagnosed with syphilis, revealed that 21 of these newborns were born with neurosyphilis (RIBEIRO et al, 2020). According to the 2022 epidemiological bulletin, in Brazil, between 2011 and 2021, only 45.3% of children with congenital syphilis underwent the recommended CSF test for the diagnosis of neurosyphilis (MINISTÉRIO DA SAÚDE, 2022).…”

Section: Discussionmentioning

confidence: 99%

Neurosyphilis in Pediatric Population: A Review of Cases

Calado Cabral,

Cañedo,

Rossato

et al. 2024

Arq. Ciênc. Saúde Unipar

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Background: Neurosyphilis is the most severe presentation of acquired and congenital syphilis, it occurs when Treponema pallidum penetrates the central nervous system. This development can occur at any time during the evolution of the disease phases. In Brazil in 2021, 2,343 children born with congenital syphilis were diagnosed with neurosyphilis, representing 9.3% of the total. The objective of this study was to analyze the scientific evidence on the medical manifestations presented by pediatric patients affected by neurosyphilis. Methods: In February 2023, PubMed, VHL, Scopus, Lilacs and Bdenf databases were researched for published case reports of patients aged zero to less than 18 years with T. pallidum infection. The data analysis period covered 55 years. Results: Nine articles were found in the period of publication from 1967 to 2022. There were two cases in females and only one with manifestation in an adolescent of acquired neurosyphilis. The adolescent's case was the only one with a favorable outcome after adequate treatment. Other cases resulted in impaired quality of life for patients and family members involved in child care. Conclusion: The reported cases of neurosyphilis were mostly related to late diagnosis. Evidencing the fragility of prenatal care, which is crucial for prevention and intervention by T. pallidum infection causes serious consequences for child development. Therefore, control measures should focus on mandatory prenatal screening during the first trimester of pregnancy, partner notification, prompt treatment and postnatal follow-up of the newborn.

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“…For syphilis patients, antenatal treatment has demonstrated high efficacy in reducing the risk of congenital syphilis with the dose of at least 2.4 MU penicillin given at least 28 days before delivery ( 154 ). However, a case-control study revealed that treatment of neurosyphilis remains difficult, even if most pregnant women with syphilis are treated with penicillin, and that this is related to inadequate treatment of sexual partners ( 155 ). Effective management and control of neurosyphilis continues to face significant obstacles.…”

Section: Prevention Of Neurosyphilismentioning

confidence: 99%

Neurosyphilis: insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention

Wu,

Ye,

Wang

et al. 2024

Front. Neurol.

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Background and aimInvasion of the central nervous system by Treponema pallidum can occur at any stage of syphilis. In the event that T. pallidum is not cleared promptly, certain individuals may experience progression to neurosyphilis, which manifests as cognitive and behavioral abnormalities, limb paralysis, and potentially fatal outcomes. Early identification or prevention of neurosyphilis is therefore crucial. The aim of this paper is to conduct a critical and narrative review of the latest information focusing exclusively to the pathogenesis and clinical management of neurosyphilis.MethodologyTo compile this review, we have conducted electronic literature searches from the PubMed database relating to neurosyphilis. Priority was given to studies published from the past 10 years (from 2013 to 2023) and other studies if they were of significant importance (from 1985 to 2012), including whole genome sequencing results, cell structure of T. pallidum, history of genotyping, and other related topics. These studies are classic or reflect a developmental process.ResultsNeurosyphilis has garnered global attention, yet susceptibility to and the pathogenesis of this condition remain under investigation. Cerebrospinal fluid examination plays an important role in the diagnosis of neurosyphilis, but lacks the gold standard. Intravenous aqueous crystalline penicillin G continues to be the recommended therapeutic approach for neurosyphilis. Considering its sustained prominence, it is imperative to develop novel public health tactics in order to manage the resurgence of neurosyphilis.ConclusionThis review gives an updated narrative description of neurosyphilis with special emphasis on its pathogenesis, susceptibility, diagnosis, treatment, and prevention.

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Neurosyphilis in Brazilian newborns: a health problem that could be avoided

Cited by 9 publications

References 18 publications

The Clinical Characteristics and Serological Outcomes of Infants With Confirmed or Suspected Congenital Syphilis in Shanghai, China: A Hospital-Based Study

The Clinical Characteristics and Serological Outcomes of Infants With Confirmed or Suspected Congenital Syphilis in Shanghai, China: A Hospital-Based Study

Neurosyphilis in Pediatric Population: A Review of Cases

Neurosyphilis: insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention

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