TY  - CHAP
M1  - Book, Section
TI  - Syphilis
A1  - Gomella, Tricia Lacy
A1  - Eyal, Fabien G.
A1  - Bany-Mohammed, Fayez
PY  - 2020
T2  - Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e
AB  - Syphilis  is  a  sexually  transmitted  infection  caused  by  Treponema  pallidum,  which  is  a  thin,  motile  spirochete  that  is  extremely  fastidious,  surviving  only  briefly  outside  the  host.  The  Centers  for  Disease  Control  and  Prevention  (CDC)  issued  a  case  definition  of  congenital  syphilis  (CS)  in  2018  as  follows:  a  condition  caused  by  infection  in  utero  with  T  pallidum.  A  wide  spectrum  of  severity  exists,  from  inapparent  infection  to  severe  cases  that  are  clinically  apparent  at  birth.  Laboratory  criteria  for  diagnosis  entail  demonstration  of  T  pallidum  by:  (1)  darkfield  microscopy  of  lesions,  body  fluids,  or  neonatal  nasal  discharge;  or  (2)  polymerase  chain  reaction  (PCR)  or  other  equivalent  direct  molecular  methods  of  lesions,  neonatal  nasal  discharge,  placenta,  umbilical  cord,  or  autopsy  material;  or  (3)  immunohistochemistry  or  special  stains  (eg,  silver  staining)  of  specimens  from  lesions,  placenta,  umbilical  cord,  or  autopsy  material.  Cases  are  classified  as  confirmed  (by  laboratory  diagnosis)  or  probable.  Probable  CS  is  a  condition  affecting  an  infant  whose  mother  had  untreated  or  inadequately  treated  syphilis  at  delivery,  regardless  of  signs  in  the  infant,  or  an  infant  or  child  who  has  a  reactive  nontreponemal  test  for  syphilis  (Venereal  Disease  Research  Laboratory  [VDRL],  rapid  plasma  reagin  [RPR],  or  equivalent  serologic  methods)  and  any  1  of  the  following:  (1)  any  evidence  of  CS  on  physical  examination;  (2)  any  evidence  of  CS  on  radiographs  of  long  bones;  (3)  a  reactive  cerebrospinal  fluid  (CSF)  VDRL  test;  (4)  an  elevated  CSF  leukocyte  (white  blood  cell  [WBC])  count  or  protein  (without  other  cause)  in  a  nontraumatic  lumbar  puncture.  Suggested  parameters  for  abnormal  CSF  WBC  and  protein  values  include  the  following:  during  the  first  30  days  of  life,  a  CSF  WBC  count  of  >15  WBC/mm3  or  a  CSF  protein  >120  mg/dL  is  abnormal;  after  the  first  30  days  of  life,  a  CSF  WBC  count  of  >5  WBC/mm3  or  a  CSF  protein  >40  mg/dL  is  abnormal,  regardless  of  CSF  serology.  Adequate  treatment  is  defined  as  completion  of  a  penicillin-based  regimen,  in  accordance  with  CDC  treatment  guidelines,  appropriate  for  stage  of  infection,  initiated  ≥30  days  before  delivery.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/17
UR  - accesspediatrics.mhmedical.com/content.aspx?aid=1168359004
ER  -