Congenital syphilis: a misleading disease

Abstract

Sexually transmitted diseases, mainly syphilis, are a public health problem. Syphilis is a disease caused by a bacterium of the spirochete type Treponema Pallidum, can be transmitted through sexual and maternal-fetal, acquired and congenital routes, respectively. The affectation is systemic, with chronic evolution and sometimes asymptomatic. The probability of congenital infection will depend on the stage of the mother and the time of appearance, generally after the 16th week of pregnancy. Syphilis during pregnancy produces risk to the mother and the child, so the treatment must be for both: the infectious process of the pregnant woman must be treated and prevent intrauterine infection of the fetus. There are risk factors that can cause an increase in cases of this sexually transmitted disease such as: Poor reproductive health education, lack of prenatal health control, few or non-access to laboratory tests, multiple partners, intravenous drugs, sex workers and history of syphilis in previous pregnancies or sexually transmitted diseases. Congenital syphilis is a controversial disease, since more than 50% of children who suffer from it at birth are asymptomatic and its symptoms usually appear during the first three months of life. It can be divided into two typical syndromes: early congenital (in the first two years of life) and late congenital (after 2 years). Early detection of syphilis in pregnancy is essential, ideally at the first prenatal appointment. Screening should be repeated between weeks 28 and 32 of pregnancy and during birth of high risk. The most used test is the VDRL, sexual clinical history and physical examination and the confirmation is the conventional treponemal tests (FTA-ABS and TPPA). Benzathine benzylpenicillin is the only effective and safe drug to use during pregnancy and to the fetus, since it crosses the placental barrier.