Abnormal Development - Syphilis: Difference between revisions
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The following information is based upon the 2003 CDC guidelines.<ref>'''Congenital Syphilis Case Investigation and Reporting Form Instructions''' [http://www.cdc.gov/std/Program/ConSyphInstr11-2003.pdf PDF]</ref> | The following information is based upon the 2003 CDC guidelines.<ref>'''Congenital Syphilis Case Investigation and Reporting Form Instructions''' [http://www.cdc.gov/std/Program/ConSyphInstr11-2003.pdf PDF]</ref> | ||
===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 | :A. any infant whose mother had untreated or inadequately treated1 syphilis at the time of | ||
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===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. | |||
==Australian Data== | ==Australian Data== |
Revision as of 13:27, 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).
Some Recent Findings
|
Treponema pallidum
Congenital Syphilis
The following information is based upon the 2003 CDC guidelines.[3]
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.
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, May 13) 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