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Year : 2016  |  Volume : 34  |  Issue : 1  |  Page : 111--112

Congenital syphilis in the era of decreasing seroprevalence

A Baidya, A Ghosh, S Chopra, A Garg, S Sood, A Kapil, BK Das 
 Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
B K Das
Department of Microbiology, All India Institute of Medical Sciences, New Delhi
India

How to cite this article:
Baidya A, Ghosh A, Chopra S, Garg A, Sood S, Kapil A, Das B K. Congenital syphilis in the era of decreasing seroprevalence.Indian J Med Microbiol 2016;34:111-112

How to cite this URL:
Baidya A, Ghosh A, Chopra S, Garg A, Sood S, Kapil A, Das B K. Congenital syphilis in the era of decreasing seroprevalence. Indian J Med Microbiol [serial online] 2016 [cited 2020 Dec 1 ];34:111-112
Available from: https://www.ijmm.org/text.asp?2016/34/1/111/167674

Full Text

Dear Editor,

Occurrence of congenital syphilis reflects a failure of antenatal care delivery systems. Recently reports from many developed nations have observed a spurt in the incidence of syphilis.[1] Diagnosis of congenital syphilis is problematic since more than half of all infants are asymptomatic at birth and the treatment delay can lead to irreversible sequelae.

A newborn male whose mother was a confirmed case of syphilis had Venereal Disease Research Laboratory (VDRL) (Institute of Serology, Calcutta, India) reactivity titre of 1:8 at birth and 1:16 at day 3 of life. Further the diagnosis was confirmed using Treponema pallidum haemagglutination assay (TPHA) (Plasmatec, Bridport Dorset, U.K). The biochemical and cytological results of cerebrospinal fluid (CSF) were within normal limits. CSF VDRL was non-reactive. X-ray showed normal bony skeleton. The baby apparently appeared normal. The mother had history of painless genital ulcer 2 years back and reactive VDRL test during pregnancy. She was advised benzathine penicillin, though it was not received by her. She was again tested at the time of delivery. The VDRL titre was significant (1:16). Father was a healthcare worker and tested reactive to VDRL (titre 1:32) and positive for TPHA. Newborn was given crystalline penicillin for 10 days and parents were administered 3 doses of 1.2 million units benzathine penicillin weekly.

The treatment response was monitored after 2½ months. The child was reactive to VDRL in serum without dilution, and the parents were reactive to VDRL in 1:2 dilutions showing a significant response to treatment. All of them tested positive for TPHA (1:640) and negative for HIV by serological methods.

This case highlights that despite education and awareness there can be such cases in the community. Though there is an overall decrease in seroprevalence of syphilis in India,[2],[3],[4] occurrence of these cases do challenge the on-going control programmes.

References

1Promed Mail: International Society for Infectious Diseases. Available from: http://www.promedmail.org/. [Last accessed on 2014 Mar 18].
2Sethi S, Sharma K, Dhaliwal LK, Banga SS, Sharma M. Declining trends in syphilis prevalence among antenatal women in Northern India: A 10-year analysis from a tertiary healthcare centre. Sex Transm Infect 2007;83:592.
3Sharma A, Rawat D, Bhalla P. Trend of syphilis in a tertiary care hospital, New Delhi: 2001-2009. Indian J Public Health 2013;57:117-8.
4Chopra S, Garg A, Chopra M, Ghosh A, Sreenivas V, Sood S, et al. Declining trends of Syphilis seroprevalance among antenatal clinic cases and STD clinic cases in a tertiary care centre: From January 2002 to December 2012. Indian J Med Microbiol 2015;33 Suppl: 126-8.