Congenital syphilis in Argentina: Experience in a pediatric hospital.
In spite of being preventable, Congenital syphilis (CS) is still an important, and growing health problem worldwide. Fetal infection can be particularly aggressive, but newborns can be asymptomatic at birth and, if left untreated, develop systemic compromise afterwards with poor prognosis. We analyz...
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ftdoajarticles:oai:doaj.org/article:70a921afa70b41678009f60f3018b403 2023-05-15T15:13:13+02:00 Congenital syphilis in Argentina: Experience in a pediatric hospital. Luciana Noemí Garcia Alejandra Destito Solján Samanta Moroni Nicolas Falk Nicolás Gonzalez Guillermo Moscatelli Griselda Ballering Facundo García Bournissen Jaime M Altcheh 2021-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0009010 https://doaj.org/article/70a921afa70b41678009f60f3018b403 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0009010 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009010 https://doaj.org/article/70a921afa70b41678009f60f3018b403 PLoS Neglected Tropical Diseases, Vol 15, Iss 1, p e0009010 (2021) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2021 ftdoajarticles https://doi.org/10.1371/journal.pntd.0009010 2022-12-31T09:15:21Z In spite of being preventable, Congenital syphilis (CS) is still an important, and growing health problem worldwide. Fetal infection can be particularly aggressive, but newborns can be asymptomatic at birth and, if left untreated, develop systemic compromise afterwards with poor prognosis. We analyzed 61 CS diagnosis cases between 1987-2019 presenting at the Buenos Aires Children' Hospital. The distribution of cases showed a bimodal curve, with a peak in 1992-1993 and in 2014-2017. Median age at diagnosis was 2 months (IQ 1-6 months). The main clinical findings were: bone alterations (59%); hepatosplenomegaly (54.1%); anemia (62.8%); skin lesions (42.6%) and renal compromise (33.3%). Cerebrospinal fluid (CSF) was abnormal in 5 patients, normal in 45 and was not available for 11 patients. Remarkably, spinal lumbar puncture did not modify therapeutic decisions in any case. Between mothers, only 46% have been tested for syphilis during pregnancy and 60.5% patients had non-treponemal titers equal to or less than fourfold the maternal titer. Intravenous penicillin G was prescribed for all except one patient, who received ceftriaxone with good therapeutic response. During follow-up, 1.6% infants died, 6.5% had persistent kidney disorders and 1.6% showed bone sequelae damage. RPR titers decreased after treatment, reaching negative seroconversion in 43% subjects at a median of 26.4 months. Low adherence to follow up was observed due to inherent vulnerable and low-income population characteristics in our cohort. Our results highlight a rising tendency in cases referred for CS in our population with high morbidity related to delayed diagnosis. A good therapeutic response was observed. CS requires a greater effort from the health system to adequately screen for this disease during pregnancy, and to detect cases earlier, to provide an adequate diagnosis and treatment. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Argentina PLOS Neglected Tropical Diseases 15 1 e0009010 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Luciana Noemí Garcia Alejandra Destito Solján Samanta Moroni Nicolas Falk Nicolás Gonzalez Guillermo Moscatelli Griselda Ballering Facundo García Bournissen Jaime M Altcheh Congenital syphilis in Argentina: Experience in a pediatric hospital. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
In spite of being preventable, Congenital syphilis (CS) is still an important, and growing health problem worldwide. Fetal infection can be particularly aggressive, but newborns can be asymptomatic at birth and, if left untreated, develop systemic compromise afterwards with poor prognosis. We analyzed 61 CS diagnosis cases between 1987-2019 presenting at the Buenos Aires Children' Hospital. The distribution of cases showed a bimodal curve, with a peak in 1992-1993 and in 2014-2017. Median age at diagnosis was 2 months (IQ 1-6 months). The main clinical findings were: bone alterations (59%); hepatosplenomegaly (54.1%); anemia (62.8%); skin lesions (42.6%) and renal compromise (33.3%). Cerebrospinal fluid (CSF) was abnormal in 5 patients, normal in 45 and was not available for 11 patients. Remarkably, spinal lumbar puncture did not modify therapeutic decisions in any case. Between mothers, only 46% have been tested for syphilis during pregnancy and 60.5% patients had non-treponemal titers equal to or less than fourfold the maternal titer. Intravenous penicillin G was prescribed for all except one patient, who received ceftriaxone with good therapeutic response. During follow-up, 1.6% infants died, 6.5% had persistent kidney disorders and 1.6% showed bone sequelae damage. RPR titers decreased after treatment, reaching negative seroconversion in 43% subjects at a median of 26.4 months. Low adherence to follow up was observed due to inherent vulnerable and low-income population characteristics in our cohort. Our results highlight a rising tendency in cases referred for CS in our population with high morbidity related to delayed diagnosis. A good therapeutic response was observed. CS requires a greater effort from the health system to adequately screen for this disease during pregnancy, and to detect cases earlier, to provide an adequate diagnosis and treatment. |
format |
Article in Journal/Newspaper |
author |
Luciana Noemí Garcia Alejandra Destito Solján Samanta Moroni Nicolas Falk Nicolás Gonzalez Guillermo Moscatelli Griselda Ballering Facundo García Bournissen Jaime M Altcheh |
author_facet |
Luciana Noemí Garcia Alejandra Destito Solján Samanta Moroni Nicolas Falk Nicolás Gonzalez Guillermo Moscatelli Griselda Ballering Facundo García Bournissen Jaime M Altcheh |
author_sort |
Luciana Noemí Garcia |
title |
Congenital syphilis in Argentina: Experience in a pediatric hospital. |
title_short |
Congenital syphilis in Argentina: Experience in a pediatric hospital. |
title_full |
Congenital syphilis in Argentina: Experience in a pediatric hospital. |
title_fullStr |
Congenital syphilis in Argentina: Experience in a pediatric hospital. |
title_full_unstemmed |
Congenital syphilis in Argentina: Experience in a pediatric hospital. |
title_sort |
congenital syphilis in argentina: experience in a pediatric hospital. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2021 |
url |
https://doi.org/10.1371/journal.pntd.0009010 https://doaj.org/article/70a921afa70b41678009f60f3018b403 |
geographic |
Arctic Argentina |
geographic_facet |
Arctic Argentina |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 15, Iss 1, p e0009010 (2021) |
op_relation |
https://doi.org/10.1371/journal.pntd.0009010 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009010 https://doaj.org/article/70a921afa70b41678009f60f3018b403 |
op_doi |
https://doi.org/10.1371/journal.pntd.0009010 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
15 |
container_issue |
1 |
container_start_page |
e0009010 |
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1766343796501512192 |