Syphilis in Neonates and Infants

This study was developed to investigate the expression of TOLL2, TARC and MDC in placenta tissue of pregnant patients infected with syphilis and their clinical significance. For this aim, placenta samples were collected from five pregnant patients co-infected with syphilis and five undergoing full-term delivery before RT-PCR was performed to detect the mRNA expression of TLR2, TARC and MDC genes. The protein expression of TLR2, TARC and MDC genes was examined by Western Blotting. Results showed that TLR2, TARC and MDC were expressed in placental syncytiotrophoblast cells of patients with pregnancy-associated syphilis infection. TLR2 level was found significantly higher in placenta tissue of patients with pregnancy-associated syphilis infection compared with normal placenta tissue (P<0.05), so were TARC (P<0.05) and MDC genes (P<0.05). It is concluded that TOLL2, TARC and MDC levels significantly increased in the placenta tissue of pregnant patients infected with syphilis, suggesting that the three genes were involved in the molecular pathology of the patients.

A sífilis consiste em uma doença infecciosa causada pelo Treponema Pallidum, normalmente por transmissão vertical, sendo conhecida como sífilis congênita, ou, ainda, sexual, chamada de sífilis adquirida. Além disso, a contaminação pode ocorrer de forma indireta, pela utilização de objetos contaminados, como agulhas de tatuagem ou transfusão sanguínea. É considerada um problema de saúde pública, devido ao seu alto grau de incidência, majoritariamente em países de baixa renda. O registro de casos da doença tem aumentado nos últimos vinte anos. Diante do exposto, este artigo possui como objetivo revisar a literatura acerca das manifestações bucais da sífilis. Para a construção deste trabalho foi feito um levantamento bibliográfico nas bases de dados SciVerse Scopus, Scientific Eletronic Library Online (Scielo), U.S. National Library of Medicine (PUBMED) e ScienceDirect, utilizando o gerenciador de referências Mendeley. Os artigos foram coletados no período de maio a agosto de 2021 e contemplados entre os anos de 2015 a 2021. A partir da revisão narrativa da literatura, observou-se que as manifestações orais decorrentes da sífilis podem ocorrer de diversas formas, a depender do seu estágio de infecção e evolução da doença. O papel do cirurgião dentista se torna importante para o diagnóstico dos pacientes infectados, para o sucesso do tratamento das lesões orais, melhorando seu prognostico e qualidade de vida.

A case of vertical transmission in a 35-year-old pregnant woman, gravida 4, para 2 with an unknown medical history of carrying primary syphilis is described. A routine 3rd trimester scan was performed at 30 + 5 weeks of pregnancy, which revealed fetal growth restriction (FGR) associated with absent fetal movement, a pathologic neuroscan characterized by cortical calcifications and ominous Doppler waveform analysis of the umbilical artery and ductus venosus. Computerized electronic fetal monitoring (EFM) showed a Class III tracing, according to the American College of Obstetricians and Gynecologists (ACOG) guidelines. An emergency C-section was performed and a female newborn weighing 1470 g was delivered. The Apgar scores were 5 and 8 at the first and fifth min, respectively. Besides the prompted obstetrical and neonatal interventions, the neonate died after 7 days. A histologic examination of the placenta revealed a chorioamnionitis at stage 1/2 and grade 2/3. The parenchyma showed diffuse delayed villous maturation, focal infarcts, and intraparenchymal hemorrhages. The decidua presented with chronic deciduitis with plasma cells. The parents declined the autopsy. Congenital syphilis is an emerging worldwide phenomenon and the multidisciplinary management of the mother and the fetus should be mandatory.