Latent Syphilis Infection in Pregnancy: An Ultrasound Diagnosed Case of Penicillin Treatment Failure

Lucia Pasquini,Elena Rita Magro-Malosso,Mariarosaria Di Tommaso,Michele Trotta,Adalgisa Cordisco

doi:10.1155/2018/8706738

Lucia Pasquini, Elena Rita Magro-Malosso + Show 3 more

Open Access

https://doi.org/10.1155/2018/8706738

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Abstract

We report a case of early latent syphilis (reactive serologic tests without clinical evidence of disease within 24 months from the onset of the infection) in pregnancy. Despite an appropriate maternal treatment with benzathine penicillin G, sonographic signs of fetal syphilis were detected. Follow-up scans, in addiction to serial serological tests, have allowed the identification of fetal infection and therefore the failure of antibiotic therapy. We highlight the importance of ultrasound in suspecting fetal infection and in evaluation of the fetal response after penicillin treatment.

Highlights

Syphilis in pregnancy continues to be an important public health problem despite the fact that laboratory investigations and effective treatment have been well established for many years
Penicillin is effective against Treponema pallidum and represents the drug of choice during pregnancy
We present a case of congenital syphilis in which follow-up scans, in addiction to serial serological tests, have allowed the identification of fetal infection and the failure of antibiotic therapy

Summary

Introduction

Syphilis in pregnancy continues to be an important public health problem despite the fact that laboratory investigations and effective treatment have been well established for many years. Penicillin is effective against Treponema pallidum and represents the drug of choice during pregnancy. This treatment may not always prevent fetal infection even when administered with a recommended regimen. Treatment failure has been reported in women treated in the first trimester the risk of transmission from an infected mother to her fetus seems to be higher in pregnant women treated during the third trimester [1]. We present a case of congenital syphilis in which follow-up scans, in addiction to serial serological tests, have allowed the identification of fetal infection and the failure of antibiotic therapy

Case Report

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Conclusions