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Neonates at risk for congenital syphilis: radiographic and cerebrospinal fluid evaluations

Ajay J Talati1, Padmaja Koneru

  • 1Departments of Pediatrics and Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee, USA. atalati@uthsc.edu

Southern Medical Journal
|November 18, 2011
PubMed

Insights

Congenital syphilis evaluations in infants are crucial. Diagnostic tests like cerebrospinal fluid (CSF) VDRL and radiography show low positive rates, suggesting targeted use based on infant symptoms and treatment plans.

Area of Science:

  • Neonatalogy
  • Infectious Diseases
  • Pediatric Diagnostics

Background:

  • Congenital syphilis (CS) poses risks to newborns.
  • Effective evaluation strategies are essential for preventing long-term complications.
  • Syphilis in pregnancy remains a significant public health concern.

Purpose of the Study:

  • To review infants at risk for congenital syphilis (CS).
  • To determine the optimal use of diagnostic evaluations for CS.
  • To assess the utility of cerebrospinal fluid (CSF) VDRL testing and long bone radiography.

Main Methods:

  • Retrospective chart review of infants at risk for CS (January 1997 - December 2002).
  • Identification of subjects through prenatal maternal records.
  • Data collection from infant charts with presumptive CS diagnoses.

Main Results:

  • Out of 24,245 deliveries, 250 women had reactive maternal serology.
  • Of 92 infants with presumptive CS, only 2.1% were symptomatic.
  • CSF VDRL was feasible in 80% of infants; only 1.35% tested positive. Three infants showed radiographic changes consistent with CS.

Conclusions:

  • The prevalence of syphilis in pregnancy necessitates careful neonate evaluation.
  • Low positive rates for CSF VDRL and radiography indicate a need for judicious use.
  • Diagnostic evaluations should be guided by individual infant symptoms and treatment strategies.
Abstract

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