Update on syphilis and pregnancy

While the origins of syphilis remain unknown, it has long been recognized as an infectious entity with complex pathophysiology. In this review, we highlighted the epidemiology and risk factors associated with syphilis. The incidence of syphilis in most populations showed a consistent upward trend un...

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Published in:Birth defects research Vol. 109; no. 5; pp. 347 - 352
Main Authors: Tsimis, Michael E., Sheffield, Jeanne S.
Format: Journal Article
Language:English
Published: United States 15.03.2017
Subjects:
Chancre - complications
congenital syphilis
Female
Humans
Incidence
Infectious Disease Transmission, Vertical
Male
Mass Screening
Penicillins - therapeutic use
Pregnancy
Pregnancy Complications, Infectious - diagnosis
Pregnancy Complications, Infectious - microbiology
reverse testing algorithm in syphilis
Risk Factors
Stillbirth
Syphilis - complications
Syphilis - diagnosis
Syphilis - physiopathology
Syphilis - therapy
syphilis clinical features
Syphilis Serodiagnosis - methods
Syphilis, Congenital - complications
syphilotherapy
Treponema pallidum - pathogenicity
Treponema pallidum pathogenesis
Treponema pallidum pathogenesis
syphilis clinical features
syphilotherapy
reverse testing algorithm in syphilis
congenital syphilis
ISSN:2472-1727, 2472-1727
Online Access:Get full text
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Summary:While the origins of syphilis remain unknown, it has long been recognized as an infectious entity with complex pathophysiology. In this review, we highlighted the epidemiology and risk factors associated with syphilis. The incidence of syphilis in most populations showed a consistent upward trend until the 1940s with the introduction of penicillin as the preferred treatment. The emergence of congenital syphilis and vertical transmission has been a direct result of heterosexual syphilis transmission. We also explore the microbiology and pathogenesis of Treponema pallidum as it directly correlates with its route of transmission and infectivity. The clinical features are best categorized into stages (primary, secondary, early, and late latent and tertiary). The primary stage presents as a characteristic chancre and inguinal adenopathy, while the secondary “bacteremia” stage has a predilection to dermatologic manifestations and constitutional symptoms. The latent phase of syphilis witnesses a quiescent period with variable relapse of symptoms and finally, one‐third of untreated patients undergo tertiary syphilis years after the initial infection characterized by severe neurologic or cardiovascular symptomatology. We will also review the data collected for congenital syphilis from the CDC as this can manifest with stillbirth, neonatal death, and nonimmune hydrops. The diagnosis of syphilis focuses on a combination of nontreponemal and treponemal antibody tests with the CDC recommending a traditional algorithm from screening to confirmation. However, other agencies have recently adopted the reverse testing algorithm which has outperformed the traditional algorithm in certain populations. We finally focus on syphilotherapy and monitoring response to treatment with a specific emphasis on pregnancy. Birth Defects Research 109:347–352, 2017. © 2017 Wiley Periodicals, Inc.
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ISSN:2472-1727
2472-1727
DOI:10.1002/bdra.23562