Abnormal Development - Syphilis: Difference between revisions
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In the USA before 1989, reported cases of congenital syphilis (CS) were defined and classified on the basis of a set of clinical and serologic features known as the "Kaufman criteria". In 1988, the CDC developed a new surveillance case definition "All infants born to mothers who have untreated or inadequately treated syphilis are considered potentially infected. (This criterion is based on the 70%-100% chance that during the first 4 years of infection, an untreated woman will transmit syphilis to her unborn baby)."<ref name="CDC-Congenital Syphilis">'''Congenital Syphilis Case Investigation and Reporting Form Instructions''' [http://www.cdc.gov/std/Program/ConSyphInstr11-2003.pdf PDF]</ref> | In the USA before 1989, reported cases of congenital syphilis (CS) were defined and classified on the basis of a set of clinical and serologic features known as the "Kaufman criteria". In 1988, the CDC developed a new surveillance case definition "All infants born to mothers who have untreated or inadequately treated syphilis are considered potentially infected. (This criterion is based on the 70%-100% chance that during the first 4 years of infection, an untreated woman will transmit syphilis to her unborn baby)."<ref name="CDC-Congenital Syphilis">'''Congenital Syphilis Case Investigation and Reporting Form Instructions''' [http://www.cdc.gov/std/Program/ConSyphInstr11-2003.pdf PDF]</ref> | ||
:{{Bacterial Links}} | |||
:{{Template:Environmental}} | :{{Template:Environmental}} |
Revision as of 13:54, 14 September 2011
Introduction
The variety of bacterial infections that can occur during pregnancy is as variable as the potential developmental effects, from virtually insignificant to major developmental, abortive or fatal in outcome. Some bacteria are common and are part of the normal genital tract flora (Lactobacillus sp), while other bacterial infections are less common or even rare and initially infect/transmit by air or fluids through the different epithelia (genital tract, lungs, gastrointestinal tract).
In the USA before 1989, reported cases of congenital syphilis (CS) were defined and classified on the basis of a set of clinical and serologic features known as the "Kaufman criteria". In 1988, the CDC developed a new surveillance case definition "All infants born to mothers who have untreated or inadequately treated syphilis are considered potentially infected. (This criterion is based on the 70%-100% chance that during the first 4 years of infection, an untreated woman will transmit syphilis to her unborn baby)."[1]
Bacterial Links: bacterial infection | syphilis | gonorrhea | tuberculosis | listeria | salmonella | TORCH | Environmental | Category:Bacteria |
Some Recent Findings
|
Treponema pallidum
Lineage
- Bacteria; Spirochaetes; Spirochaetes (class); Spirochaetales; Spirochaetaceae; Treponema; Treponema pallidum; Treponema pallidum subsp. pallidum;
- Treponema pallidum subsp. pallidum SS14
- Treponema pallidum subsp. pallidum str. Nichols
Congenital Syphilis
The following information is based upon the 2003 CDC Surveillance Case Definition for Congenital Syphilis.[1]
Confirmed case
Congenital syphilis is an infant or child in whom Treponema pallidum is identified by darkfield microscopy, direct fluorescent antibody, or other specific stains in specimens from lesions, placenta, umbilical cord, or autopsy material.
Presumptive case
Congenital syphilis is either of the following:
- A. any infant whose mother had untreated or inadequately treated1 syphilis at the time of delivery, regardless of the findings in the infant or child
- B. any infant or child who has a reactive treponemal test for syphilis and any one of the following:
- evidence of congenital syphilis on physical examination
- evidence of congenital syphilis on long bone X-ray
- reactive cerebrospinal fluid CSF-VDRL
- elevated CSF cell count or protein (without other cause)
- reactive test for IgM antibody.
Syphilitic stillbirth
Defined as a fetal death in which the mother had untreated or inadequately treated syphilis at the time of delivery of a fetus after a 20-week gestation or of a fetus weighing >500g.
Signs of Congenital Syphilis
In an infant or a child younger than 2 years of age may include:
- condyloma lata
- snuffles
- syphilitic skin rash
- hepatosplenomegaly
- jaundice due to syphilitic hepatitis
- pseudoparalysis
- edema from nephrotic syndrome or malnutrition
In an older child may include:
- interstitial keratitis
- nerve deafness
- anterior bowing of shins
- frontal bossing
- mulberry molars
- Hutchinson’s teeth
- saddle nose
- rhagades
- Clutton’s joints.
Australian Data
The following data is based upon a table from a recent article by Jones and Jones (2010),[4] reminding physicians to be aware of maternal and congenital syphilis.
Number of notifications of syphilis and congenital syphilis in Australia (2004 – 2007)
Year | Syphilis | Congenital syphilis | |||||
Male | Female | Total | Male | Female | Unknown | Total | |
2007 | 1231 | 150 | 1381 | 5 | 2 | 1 | 8 |
2006 | 689 | 182 | 871 | 6 | 7 | - | 13 |
2005 | - | - | 653 | 8 | 6 | 1 | 15 |
2004 | - | - | 636 | 11 | 2 | - | 13 |
Gram Stain
Bacterial staining procedure named after Hans Christian Gram (1853 - 1938). Generally divides bacteria into either:
- Gram-positive bacteria purple crystal violet stain is trapped by layer of peptidoglycan (forms outer layer of the cell).
- Gram-negative bacteria outer membrane prevents stain from reaching peptidoglycan layer in the periplasm, outer membrane then permeabilized and pink safranin counterstain is trapped by peptidoglycan layer.
Australian NHMRC Recommendations
The Australian NHMRC (1988) recommends neonates be assessed for follow-up care under the following conditions.
- Birthweight less than 1500g or gestational age less than 32 weeks
- Small-for-gestational-age neonates
- Perinatal asphyxia
- Apgar score less than 3 at 5 minutes
- clinical evidence of neurological dysfunction
- delay in onset of spontaneous respiration for more than 5 minutes and requiring mechanical ventilation
- Clinical evidence of central nervous system abnormalities ie., seizures, hypotonia
- Hyperbilirubinaemia of greater than 350umol/l in full term neonates
- Genetic, dysmorphic or metabolic disorders or a family history of serious genetic disorder
- Perinatal or serious neonatal infection including children of mothers who are HIV positive
- Psychosocial problems eg., infants of drug-addicted or alcoholic mothers.
- Links: NHMRC WWW Page
References
Reviews
<pubmed>15356936</pubmed> <pubmed>12844452</pubmed> <pubmed>10816189</pubmed> <pubmed>6293753</pubmed>
Articles
<pubmed>16458647</pubmed> <pubmed>10456962</pubmed>
Search Pubmed
Search NCBI Bookshelf: Medical Microbiology - Syphilis Search
Search PubMed: Abnormal Embryology Syphilis | Abnormal Development Syphilis
External Links
External Links Notice - The dynamic nature of the internet may mean that some of these listed links may no longer function. If the link no longer works search the web with the link text or name. Links to any external commercial sites are provided for information purposes only and should never be considered an endorsement. UNSW Embryology is provided as an educational resource with no clinical information or commercial affiliation.
- CDC (USA)
- CDC Fact Sheet - STD and Pregnancy
- CDC Fact Sheet - Syphilis
- Congenital Syphilis Case Investigation and Reporting Form Instructions PDF
- Public Health Training Network Epidemiology and Prevention of Vaccine-Preventable Diseases (viewable Webcasts requires Media Player) | Advisory Committee on Immunization Practices (ACIP) Recommendations
- Medline Plus
- Office on Women's Health (USA) Fact Sheet - Syphilis
- Royal College of Obstetricians and Gynaecologists (UK) Infection and Pregnancy - study group recommendations (Jun 2001)
Glossary Links
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Cite this page: Hill, M.A. (2024, June 16) Embryology Abnormal Development - Syphilis. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_Syphilis
- © Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G