Update on syphilis and pregnancy

Abstract

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.

Risk factors for stillbirth among pregnant women infected with syphilis from 2010–2016, Zhejiang Province, China

“…Titer decline varied with maternal disease and treatment. As previously reported, titers usually were higher and declined rapidly in primary and secondary syphilis [10,27]. Accordingly, results showed that women who suffered from stillbirth had a larger proportion of primary and secondary syphilis.…”

Recombinant Treponema pallidum protein Tp0136 promotes fibroblast migration by modulating MCP‐1/CCR2 through TLR4

“…The main characteristic of primary syphilis is that the skin infection site has a typical chancre, a painless ulceration. Interestingly, in contrast to symptoms caused by other pathogens, chancres can heal spontaneously within a few weeks without treatment . At present, the mechanism of wound healing in syphilis is still unknown.…”

“…Interestingly, in contrast to symptoms caused by other pathogens, chancres can heal spontaneously within a few weeks without treatment. 3 At present, the mechanism of wound healing in syphilis is still unknown.…”

Validação De Programa Eletrônico Para Seguimento Do Recém-Nascido Com Sífilis Congênita

“…A Sífilis Congênita (SC) é decorrente da disseminação do Treponema pallidum, via transplacentária da gestante não tratada ou tratada inadequadamente para o seu concepto em qualquer momento da gestação. A infecção pode causar consequências graves para o concepto, desde sequelas neurológicas até o óbito fetal (1,4) .…”