Objective: To analyze the association between different treatment timings and adverse neonatal outcomes (premature birth, death, congenital syphilis) in syphilis-infected pregnant women. Methods: The National Management Information System for Prevention of HIV, Syphilis and HBV Mother-to-Child Transmission was used to collect information on the detection and treatment of syphilis-infected pregnant women and their newborns in Guangdong Province from October 2011 to December 2021. According to the gestational weeks of syphilis-infected pregnant women receiving penicillin treatment for the first time, they were divided into four groups: treatment in the first trimester, treatment in the second trimester, treatment in the third trimester, and no treatment during pregnancy. Multivariate logistic regression was used to analyze the association between different treatment timings and adverse neonatal outcomes in syphilis-infected pregnant women. Results: A total of 22 483 syphilis-infected pregnant women were included. The number of pregnant women who started treatment in the first trimester, second trimester, and third trimester and did not receive treatment during pregnancy were 4 549 (20.23%), 8 719 (38.78%), 2 235 (9.94%) and 6 980 (31.05%), respectively. Compared with pregnant women who started treatment in the first trimester, pregnant women who did not receive anti-syphilis treatment during pregnancy had increased risks of neonatal preterm birth (OR=1.42, 95%CI: 1.24-1.62), death (OR=4.27, 95%CI: 1.64-14.69) and congenital syphilis (OR=12.26, 95%CI: 6.35-27.45). At the same time, the risk of congenital syphilis in the newborns of pregnant women who started anti-syphilis treatment in the second trimester (OR=2.68, 95%CI: 1.34-6.16) and third trimester (OR=6.27, 95%CI: 2.99-14.80) also increased. Conclusion: Early initiation of anti-syphilis treatment during pregnancy in patients with syphilis can improve neonatal outcomes.
Pregnancy ; Female ; Infant, Newborn ; Humans ; Pregnant Women ; Syphilis/diagnosis* ; Pregnancy Complications, Infectious/drug therapy* ; Syphilis, Congenital/drug therapy* ; Premature Birth ; Infectious Disease Transmission, Vertical/prevention & control*

Objective: To analyze the association between different treatment timings and adverse neonatal outcomes (premature birth, death, congenital syphilis) in syphilis-infected pregnant women. Methods: The National Management Information System for Prevention of HIV, Syphilis and HBV Mother-to-Child Transmission was used to collect information on the detection and treatment of syphilis-infected pregnant women and their newborns in Guangdong Province from October 2011 to December 2021. According to the gestational weeks of syphilis-infected pregnant women receiving penicillin treatment for the first time, they were divided into four groups: treatment in the first trimester, treatment in the second trimester, treatment in the third trimester, and no treatment during pregnancy. Multivariate logistic regression was used to analyze the association between different treatment timings and adverse neonatal outcomes in syphilis-infected pregnant women. Results: A total of 22 483 syphilis-infected pregnant women were included. The number of pregnant women who started treatment in the first trimester, second trimester, and third trimester and did not receive treatment during pregnancy were 4 549 (20.23%), 8 719 (38.78%), 2 235 (9.94%) and 6 980 (31.05%), respectively. Compared with pregnant women who started treatment in the first trimester, pregnant women who did not receive anti-syphilis treatment during pregnancy had increased risks of neonatal preterm birth (OR=1.42, 95%CI: 1.24-1.62), death (OR=4.27, 95%CI: 1.64-14.69) and congenital syphilis (OR=12.26, 95%CI: 6.35-27.45). At the same time, the risk of congenital syphilis in the newborns of pregnant women who started anti-syphilis treatment in the second trimester (OR=2.68, 95%CI: 1.34-6.16) and third trimester (OR=6.27, 95%CI: 2.99-14.80) also increased. Conclusion: Early initiation of anti-syphilis treatment during pregnancy in patients with syphilis can improve neonatal outcomes.
Pregnancy ; Female ; Infant, Newborn ; Humans ; Pregnant Women ; Syphilis/diagnosis* ; Pregnancy Complications, Infectious/drug therapy* ; Syphilis, Congenital/drug therapy* ; Premature Birth ; Infectious Disease Transmission, Vertical/prevention & control*

Humans ; Infant, Newborn ; Male ; Nephrotic Syndrome ; congenital ; Syphilis, Congenital ; complications ; diagnosis ; drug therapy

Female ; Humans ; Infant, Newborn ; Male ; Serologic Tests ; Syphilis, Congenital ; diagnosis ; drug therapy

A 30-yr-old man was referred for suspicious rectal cancer because of ulcerated lesions in the rectum and a palpable mass in left inguinal area. Sigmoidoscopy showed two indurated masses and histologic evaluation of biopsy revealed obliterative endarteritis with heavy plasma cell infiltration. Both venereal disease research laboratories (VDRL) and fluorescent treponemal antibody absorption (FTA-ABS) tests were positive. After injection of penicillin G benzathine for 3 weeks, the rectal chancre and the palpable mass disappeared.
Adult ; Diagnosis, Differential ; Humans ; Male ; Rectal Diseases/*complications/drug therapy/*pathology ; Rectal Neoplasms/pathology ; Syphilis/*complications/drug therapy/*pathology

OBJECTIVETo investigate the incidence of seroresistance of syphilis and analyze its relevant factors.

METHODSThe clinical data of 131 patients with syphilis were retrospectively analyzed. The incidence of seroresistance was investigated and the correlation between seroresistance and factors including age, gender, original titer, disease course, and medications were analyzed.

RESULTSThe incidence of seroresistance was not significantly different among patients with different ages and genders, but was significantly different among patients with different disease courses, antibody titers, and medications. Patients with a baseline serum rapid plasma reagin (RPR) titer of greater than 1: 8, a latent course, or a macrolide therapy history had higher incidences of seroresistance (i. e., 61%, 45.6%, and 72.7% respectively) than those who had a lower RPR titer, a primary course, or a benzathine penicillin therapy history.

CONCLUSIONSyphilis patients with a high baseline RPR titer, a latent course, and a macrolides therapy are prone to be seroresistant.

Adolescent ; Adult ; Aged ; Female ; Humans ; Macrolides ; therapeutic use ; Male ; Middle Aged ; Reagins ; blood ; Syphilis ; blood ; diagnosis ; drug therapy ; immunology ; Syphilis Serodiagnosis ; methods ; Young Adult

No abstract available.
Anti-Bacterial Agents/therapeutic use ; Diagnosis, Differential ; Electroretinography ; Eye Infections, Bacterial/*diagnosis/drug therapy ; Fluorescein Angiography ; Humans ; Male ; Middle Aged ; Penicillin G Benzathine/therapeutic use ; Retinitis/*diagnosis/drug therapy ; Scotoma/*diagnosis/drug therapy ; Syphilis/*diagnosis/drug therapy ; Syphilis Serodiagnosis ; Tomography, Optical Coherence ; Visual Acuity/physiology

Syphilis is a sexually transmitted disease caused by Treponema pallidum. The prevalence of this disease has recently increased worldwide. However, pulmonary involvement in secondary syphilis is extremely rare. A 51-year-old heterosexual male patient presented with multiple pulmonary nodules with reactive serology from the Venereal Disease Research Laboratory test and positive fluorescent treponemal antibody absorption testing. A hematogenous metastatic malignancy was suspected and an excisional lung biopsy was performed. Histopathological examination showed only central necrosis with abscess and plasma cell infiltration, but no malignant cells. The patient reported sexual contact with a prostitute 8 weeks previously and a penile lesion 6 weeks earlier. Physical examination revealed an erythematous papular rash on the trunk. Secondary syphilis with pulmonary nodules was suspected, and benzathine penicillin G, 2.4 million units, was administered. Subsequently, the clinical signs of syphilis improved and the pulmonary nodules resolved. The final diagnosis was secondary syphilis with pulmonary nodular involvement.
Anti-Bacterial Agents/therapeutic use ; Biopsy ; Diagnosis, Differential ; Humans ; Lung Neoplasms/diagnosis ; Male ; Middle Aged ; Multimodal Imaging ; Multiple Pulmonary Nodules/diagnosis/drug therapy/*microbiology ; Penicillin G Benzathine/therapeutic use ; Predictive Value of Tests ; Prostitution ; Respiratory Tract Infections/diagnosis/drug therapy/*microbiology/transmission ; Sex Workers ; Syphilis/*diagnosis/drug therapy/*microbiology/transmission ; Syphilis Serodiagnosis ; Tomography, X-Ray Computed ; Treatment Outcome ; Unsafe Sex

BACKGROUND: Automated Mediace Treponema pallidum latex agglutination (TPLA) and Mediace rapid plasma reagin (RPR) assays are used by many laboratories for syphilis diagnosis. This study compared the results of the traditional syphilis screening algorithm and a reverse algorithm using automated Mediace RPR or Mediace TPLA as first-line screening assays in subjects undergoing a health checkup. METHODS: Samples from 24,681 persons were included in this study. We routinely performed Mediace RPR and Mediace TPLA simultaneously. Results were analyzed according to both the traditional algorithm and reverse algorithm. Samples with discordant results on the reverse algorithm (e.g., positive Mediace TPLA, negative Mediace RPR) were tested with Treponema pallidum particle agglutination (TPPA). RESULTS: Among the 24,681 samples, 30 (0.1%) were found positive by traditional screening, and 190 (0.8%) by reverse screening. The identified syphilis rate and overall false-positive rate according to the traditional algorithm were lower than those according to the reverse algorithm (0.07% and 0.05% vs. 0.64% and 0.13%, respectively). A total of 173 discordant samples were tested with TPPA by using the reverse algorithm, of which 140 (80.9%) were TPPA positive. CONCLUSIONS: Despite the increased false-positive results in populations with a low prevalence of syphilis, the reverse algorithm detected 140 samples with treponemal antibody that went undetected by the traditional algorithm. The reverse algorithm using Mediace TPLA as a screening test is more sensitive for the detection of syphilis.
Algorithms ; Anti-Bacterial Agents/therapeutic use ; Humans ; Latex Fixation Tests ; Reagins/blood ; Syphilis/*diagnosis/drug therapy/microbiology ; Treponema pallidum/isolation & purification

Biomarkers ; analysis ; Delayed Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Infant, Newborn ; Liver Diseases ; diagnosis ; drug therapy ; etiology ; Liver Function Tests ; Nephrotic Syndrome ; diagnosis ; drug therapy ; etiology ; Penicillin G ; administration & dosage ; therapeutic use ; Skin Diseases ; diagnosis ; drug therapy ; etiology ; Syphilis, Congenital ; complications ; diagnosis ; drug therapy