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1.
Clin Dermatol ; 39(4): 710-713, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34809778

RESUMO

Restrictive measures to contain the coronavirus disease 2019 (COVID-19) pandemic might produce different effects on other infective diseases, especially those affecting the most intimate sphere of sexuality. The epidemiology of syphilis could reflect the consequences of whether people are avoiding or not risky behaviors. To understand the course of syphilis during the COVID-19 outbreak, we performed a retrospective observational study of all new diagnoses observed at the STDs Service of the Dermatology Clinic at Cagliari, part of the Italian sentinel surveillance system. All incident cases diagnosed during the first 6 months of each year, from 2016 to 2020, thus including the recent lockdown period, were retrieved from the database. Of the 87 cases studied, 18 occurred during the first 6 months of 2020, almost all patients (88%) presenting with early phases of the disease and reporting unprotected sexual intercourses in spite of community containment and social distancing. Comparison with the previous 4 years found no significant statistical differences that hospital access and management limitations had not impaired the management of patients with syphilis. We alert the medical community of the possible increase of sexually transmitted diseases, as society returns to normal.


Assuntos
COVID-19 , Sífilis , Controle de Doenças Transmissíveis , Humanos , Pandemias , SARS-CoV-2 , Comportamento Sexual , Sífilis/diagnóstico , Sífilis/epidemiologia , Sífilis/prevenção & controle
2.
Clin Dermatol ; 39(4): 714-717, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34809779

RESUMO

Disorders with dermatologic features are intractable and rife in Shakespeare's world. For this reason, they occupy an unusual position in culture. "The plague" and "leprosy" are popular insults and epithets-indictments of not external pathogens but of moral failure. It may be no surprise to identify, as a present-day reader, syphilis and the plague in early modern England, but what about other dermatologic conditions at the time? "The plague," "leprosy," "the pox," and "measles" are commonly used terms, although ultimately interchangeable in Shakespeare's plays. Rosacea and scurvy, however, are described by Shakespeare before they become named entities. Bardolph's skin characterizes his alcohol addiction and thievery, and Caliban's "monstrous" form mirrors his state as an untouchable in society. Shakespeare also documents the "royal touch" in Macbeth, which links the ability of a monarch to heal the skin lesions of extrapulmonary tuberculosisto political legitimacy. Shakespeare does little more than document this historic ritual around the skin, but he does catalogue the ways these acquired diseases of the skin are used in daily speech and character writing. At the end of Macbeth, the "royal touch" gives Prince Malcolm the backstory and political precedent to march on Dunsinane Hill to reclaim the Scottish throne.


Assuntos
Drama , Medicina na Literatura , Rosácea , Sífilis , Humanos , Masculino , Pele , Sífilis/diagnóstico
3.
AIDS Patient Care STDS ; 35(11): 435-440, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34739335

RESUMO

Syphilis rates have continued to rise in the United States. Florida and Louisiana consistently report high numbers of cases. We evaluated rates of reinfection to see if frequent rescreening might lead to earlier treatment and prevent infections. All syphilis records of all stages for males and females aged 15-70 years from the Florida and Louisiana Departments of Health surveillance databases 2000-2018 were evaluated. The first episode of syphilis during this period was considered the initial diagnosis for each person. Demographics of cases and repeaters (individuals reported with two or more cases of syphilis) were examined. Percentages of syphilis cases from repeaters by year were calculated as were percentages from HIV+ males. During 2000-2018, 124,827 syphilis cases were reported from 107,405 individuals: 73,811 (68.7%) males; 33,594 (31.3%) females. There were 12,545 individuals (repeaters) with two or more syphilis diagnoses (n = 17,422 cases; range, 2-10). From 2010 to 2018, repeaters accounted for steadily increasing percentage of all syphilis reported: 2010 (11%), 2013 (16%), 2015 (20%), and 2018 (26%). Among HIV+ male cases the percentage from repeaters also increased: 2010 (28%), 2013 (35%), 2015 (42%), and 2018 (50%). In 2018, 19% of all cases (n = 2455) were from HIV+ males who had a previous syphilis diagnosis. Among HIV+ males diagnosed with syphilis in 2015, 34% had a repeat syphilis diagnosis within 3 years. Most syphilis diagnosed in Florida and Louisiana was among persons infected for the first time. However, some subgroups could possibly benefit from more frequent screening. Males living with HIV who had a prior syphilis diagnosis were at very high risk of repeat infection.


Assuntos
Infecções por HIV , Sífilis , Feminino , Florida/epidemiologia , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Louisiana/epidemiologia , Masculino , Sífilis/complicações , Sífilis/diagnóstico , Sífilis/epidemiologia , Estados Unidos
4.
J Med Case Rep ; 15(1): 552, 2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34749803

RESUMO

INTRODUCTION: Neurosyphilis is an infection caused by the spirochete Treponema pallidum, which causes infiltration and thickening of brain meninges. Despite being an Old World disease, the rates of infection continue to rise. This clinical challenge involves early and accurate diagnosis, as neurosyphilis masquerades with various clinical symptoms and is often missed during initial presentation to the hospital. A comprehensive history and clinical examination are essential to detect suspicious cases early for further cerebrospinal fluid examination and neuroimaging. Patients treated with benzylpenicillin for a specific duration often show promising clinical and cognitive improvement, thus emphasizing the need for constant vigilance in our day-to-day practice. CASE PRESENTATION: A 77-year-old Caucasian gentleman presented to our hospital repeatedly with multiple episodes of presyncope and cognitive impairment. He also demonstrated bilateral deafness, tabes dorsalis, and left sixth cranial nerve palsy. His cerebrospinal fluid examination showed a nonreactive venereal disease research laboratory test, and magnetic resonance imaging of the brain revealed a gumma. CONCLUSION: The diagnosis of neurosyphilis in the elderly requires a combination of clinical vigilance and a high index of suspicion, along with multimodal investigations, including cerebrospinal fluid examination and brain imaging.


Assuntos
Neurossífilis , Sífilis , Idoso , Austrália , Humanos , Masculino , Neurossífilis/complicações , Neurossífilis/diagnóstico , Neurossífilis/tratamento farmacológico , Sorodiagnóstico da Sífilis , Treponema pallidum
5.
Rev Saude Publica ; 55: 68, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34730749

RESUMO

OBJECTIVE: To analyze the evolution of syphilis during pregnancy notification regarding clinical classification, diagnosis and treatment in the state of Goiás, Brazil, between 2007 and 2017. METHODS: This is a time-series study, analyzing data provided by the Health Secretariat of the state of Goiás. The variables related to the diagnosis and treatment of pregnant women and their partners were analyzed, and their evolution trend during the years. Descriptive statistics and percentage calculation were used. Cochran-Armitage test with a significance level α = 0.05 was used to determine increase and decrease trends. RESULTS: During the period, 7,774 cases were notified. The highest percentage of notifications occurred in the second trimester of pregnancy (39.8%) and corresponded to primary syphilis (34.1%). The most frequent treatment prescribed was benzathine benzylpenicillin with a dosage of 7.2 million (43.8%). Between 2007 and 2017, there was an increasing trend in the notification percentage of latent (14.1% to 30.7%), secondary (5.2% to 19%), and tertiary syphilis (4.4% to 11.4%). The treatment with benzathine benzylpenicillin with a dosage of 7.2 million also increased (19.3% to 59.6%). The percentages of primary syphilis decreased (43.4% to 22.1%), as well as other treatments' percentages. CONCLUSIONS: Latent syphilis notification of pregnant women and treatment with penicillin at the dosage of 7,200,000 IU increased. Notification forms' data completeness also increased for the variables clinical classification and treatment, suggesting improvements in the notification process.


Assuntos
Complicações Infecciosas na Gravidez , Sífilis Congênita , Sífilis , Brasil/epidemiologia , Feminino , Humanos , Penicilina G Benzatina/uso terapêutico , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/epidemiologia , Gestantes , Sífilis/diagnóstico , Sífilis/tratamento farmacológico , Sífilis/epidemiologia , Sífilis Congênita/diagnóstico , Sífilis Congênita/tratamento farmacológico , Sífilis Congênita/epidemiologia
6.
Clin Dermatol ; 39(5): 890-899, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34785018

RESUMO

St. Gallicanus Hospital in Rome, Italy, created by the will of Pope Benedict XIII (1649-1730) in 1725, was the first dermatologic hospital in the world. The strong bond between science and faith, humanitarian spirit and scientific research, and the profoundness and legacy of its entire history have all contributed to its legacy. We have traced its development by examining archival documents to understand the life of the institute and the diseases that were diagnosed and treated from the 18th century to the first half of the 20th century. Some of the main diseases were leprosy, mange, scabies, ringworm, and syphilis, which were widespread in Rome during the 18th and 19th centuries and were creating a mortal threat for much of the population. St. Gallicanus Hospital was dedicated to the diagnosis, treatment, and prevention of these diseases where possible. Special attention has been directed to syphilis and the use of penicillin therapy after its introduction in 1943, especially for curbing the extensive problems created by prostitution.


Assuntos
Escabiose , Sífilis , Academias e Institutos , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História Antiga , História Medieval , Hospitais , Humanos , Cidade de Roma , Sífilis/diagnóstico , Sífilis/tratamento farmacológico , Sífilis/epidemiologia
7.
Clin Lab ; 67(11)2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34758213

RESUMO

BACKGROUND: The WHO recommends mandatory serological testing of blood donors for hepatitis B virus, hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis. We evaluated the performance of Elecsys® infectious disease immunoassays against commercially available comparator assays. METHODS: Prospective, routine, anonymized patient or donor samples (n = 8,821) were analyzed at three German sites using Elecsys antihepatitis B core antigen (Anti-HBc II), Anti-HCV II, HIV combi PT, hepatitis B surface antigen (HBsAg II), and Syphilis immunoassays (cobas e 411 analyzer) versus ARCHITECT comparator assays. RESULTS: The Elecsys immunoassays demonstrated comparable sensitivity (≤ 1.54% difference) and equivalent specificity (≤ 0.63% difference) to the respective ARCHITECT comparator assays. Overall sensitivity for the Elecsys and ARCHITECT infectious disease panels was 99.78% vs. 99.40%, respectively, and overall specificity was 99.74% vs. 99.80%, respectively. CONCLUSIONS: The Elecsys infectious disease immunoassays demonstrated high sensitivity and specificity, which were similar to comparator assays, supporting their suitability for routine laboratory practice.


Assuntos
Infecções por HIV , Hepatite B , Hepatite C , Sífilis , Infecções por HIV/diagnóstico , Hepacivirus , Hepatite B/diagnóstico , Antígenos de Superfície da Hepatite B , Hepatite C/diagnóstico , Humanos , Imunoensaio , Estudos Prospectivos , Sensibilidade e Especificidade , Sífilis/diagnóstico
8.
Rev Assoc Med Bras (1992) ; 67(7): 991-996, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34817512

RESUMO

INTRODUCTION: Congenital syphilis is caused by the vertical transmission of bacteria, Treponema pallidum, from nontreated or inappropriately treated pregnant to the fetus. OBJECTIVE: To evaluate the clinical aspects of Congenital syphilis in Brazil, between 2009-2018. METHOD: It is an analytical cross-sectional study whose data were collected from the Department of Chronical Conditions and Sexually Transmitted Infections of Brazilian Health Ministry. Clinical variables were analyzed using the software Joinpoint Regression, which makes a segmented linear regression. RESULTS: In the study period, 156,969 cases of Congenital syphilis and 1642 deaths by this disease were reported. The trend analysis indicates growing in diagnosis of maternal syphilis during prenatal care, appropriate treatment of pregnant, realization of prenatal care, maternal partner treatment, diagnosis of syphilis in children under seven days, and diagnosis of recent syphilis. CONCLUSIONS: Although the trend analysis presents relative improvement in Congenital syphilis panorama in Brazil, the disease still related to high numbers of evitable perinatal morbidity and mortality. Therefore, the prenatal assistance with quality is fundamental to have a possible change in this field in the country.


Assuntos
Doenças Sexualmente Transmissíveis , Sífilis Congênita , Sífilis , Brasil/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Gravidez , Sífilis/diagnóstico , Sífilis/epidemiologia , Sífilis Congênita/epidemiologia
9.
Rev Esc Enferm USP ; 55: e20200578, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34605532

RESUMO

OBJECTIVE: To analyze the spatial distribution of congenital syphilis cases in a state in northeastern Brazil. METHOD: This is an ecological study, with secondary data for the period from 2008 to 2018, taking as a sample the notified cases of congenital syphilis in Rio Grande do Norte. In the data analysis, the eight health regions of the state were used as units of analysis, and the local and global Moran's I was performed, with subsequent smoothing through the local empirical Bayesian method, which resulted in thematic maps. RESULTS: The results showed an increase in cases of congenital syphilis in the 3rd and 7thhealth regions. In terms of spatial analysis, this investigation showed clusters in the 3rd, 5th, and 7thhealth regions, with an increased risk for congenital syphilis of up to 2.65 times and with an incidence rate of 7.91 cases per 1,000 live births. CONCLUSION: The spatial analysis of congenital syphilis cases allowed observing a high incidence in some health regions, with averages above those calculated for the entire state, indicating the need to implement effective strategies to achieve its control.


Assuntos
Sífilis Congênita , Teorema de Bayes , Brasil/epidemiologia , Humanos , Incidência , Análise Espacial , Sífilis Congênita/epidemiologia
10.
Przegl Epidemiol ; 75(2): 175-183, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34696554

RESUMO

We describe the case of a HIV-infected patient, in whom a secondary syphilis with skin lesions and ocular involvement developed. On admission papular skin rash and partial visual loss with left eye were observed. Serological tests for syphilis were positive in very high titers. Ophthalmological examination revealed ocular abnormalities indicating ocular syphilis. Cerebrospinal fluid (CSF) tests showed elevated concentration of immunoglobulin G (IgG) with normal white blood count and albumin concentration, serological treponemal tests for syphilis were positive. Intravenous therapy with Penicillinum Crystallisatum (Benzylpenicillinum kalicum) was administered, according to the neurosyphilis treatment schedule, achieving resolution of the skin lesions and partial vision improvement, a month after the end of the treatment a complete recovery of the vision was noted. Serological tests` for syphilis titers decreased fourfold. Described case confirms reasonability of examination for syphilis in patients with sudden vision disturbances, especially those HIV-infected. It also indicates that early appropriate treatment of the ocular syphilis prevents permanent loss of vision.


Assuntos
Oftalmopatias , Infecções por HIV , Neurossífilis , Sífilis , Oftalmopatias/complicações , Oftalmopatias/diagnóstico , Oftalmopatias/tratamento farmacológico , Infecções por HIV/complicações , Humanos , Neurossífilis/complicações , Neurossífilis/diagnóstico , Neurossífilis/tratamento farmacológico , Polônia , Sífilis/complicações , Sífilis/diagnóstico , Sífilis/tratamento farmacológico
11.
BMC Infect Dis ; 21(1): 1123, 2021 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-34717564

RESUMO

BACKGROUND: Each year, 5.6 million new syphilis cases are diagnosed globally. Guidelines for people living with HIV (PLWH) in low-income countries (LIC) recommend STI testing for symptomatic persons and those newly diagnosed with HIV; routine STI testing is less clear. Here we provide updated syphilis prevalence and identify co-infection risk factors in PLWH in the African Cohort Study (AFRICOS) to understand these rates as they relate to syndromic treatment. METHODS: AFRICOS is a study enrolling PLWH and HIV-uninfected individuals in four African countries. Participant study enrollment information was used to determine syphilis prevalence and co-infection risk factors. Inclusion criteria consisted of adults 18 years or older receiving care at a participating clinic as a long-term resident who consented to data and specimen collection. Exclusion criteria consisted of pregnancy and/or imprisonment. Screen-positive syphilis was defined as a reactive rapid plasma regain (RPR) upon study enrollment whereas confirmed syphilis included a reactive RPR followed by reactive treponemal test. Multivariate analyses was performed to determine HIV and syphilis co-infection risk factors. RESULTS: Between 2013 and March 1, 2020, 2939 PLWH enrolled and 2818 were included for analysis. Screen-positive and confirmed syphilis prevalence were 5.3% (151/2818) and 3.1% (87/2818), respectively. When the analysis was restricted to PLWH with an RPR titer of greater than, or equal to, 1:8, 11/87 (12.6%) participants were included. No PLWH and confirmed syphilis had documented genital ulcers. In the multivariate model, participants with confirmed syphilis co-infection were more likely to have none or some primary education [aOR 3.29 (1.60, 6.74)] and consume alcohol [aOR 1.87 (1.16, 3.03)] compared to those without syphilis. Antiretroviral therapy (ART) with suppressed viral load (VL) was protective in the unadjusted model but not adjusted multivariate model. CONCLUSIONS: Our findings show that syphilis rates in sub-Saharan Africa remain elevated where diagnosis remains challenging, and that both lower education level and alcohol consumption are significantly associated with HIV/syphilis co-infection in AFRICOS. Based on our analysis, current STI guidelines targeting testing for African individuals with either new HIV diagnosis or syndromic symptoms may be inadequate, highlighting the need for increased testing and treatment strategies in resource-limited settings.


Assuntos
Coinfecção , Infecções por HIV , Sífilis , Adulto , Estudos de Coortes , Coinfecção/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Gravidez , Prevalência , Fatores de Risco , Sífilis/complicações , Sífilis/epidemiologia
12.
Przegl Epidemiol ; 75(2): 151-158, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34696547

RESUMO

INTRODUCTION: COVID-19 pandemic had a big impact on the health services organisation, including that of sexually transmitted infections (STIs). AIM: To analyse and evaluate the influence of COVID-19 epidemic on the detection of STIs and healthcare services in a group of these patients on the base of the experience of the Department of Dermatology and Venereology and University Outpatient Clinic in Bialystok, Poland. MATERIAL AND METHODS: Analysis of the number of consultations for suspicion of STIs, number of newly diagnosed cases of syphilis, gonorrhoea, Chlamydia trachomatis infections and genital herpes in two periods: January 2019 - February 2020 (before the epidemic state was introduced) and March 2020 - April 2021 (during pandemic). STIs cases hospitalised in the same periods were also analysed. RESULTS: The number of hospitalisations and outpatient consultations decreased during pandemic as compared to the period before it (by 83.3% and 41.9%, respectively). Patients with syphilis constituted the majority in both periods, remaining STIs were few. During pandemic, the proportion of detected cases of syphilis was higher as compared to the time before it, despite the diminished number of consultations (39.4% and 28%, respectively). Majority of patients with syphilis were men (92.3% and 93.3%), among them men-who-have-sex-with-men constituted at least 50%. Early syphilis was diagnosed more frequently during pandemic than before it (92.3% and 78.6%, respectively), early symptomatic syphilis in particular (46.2% and 35.7%, respectively). HIV coinfection in syphilis patients was more frequent during pandemic (15.8% and 7.1%, respectively). More than half of these patients (53.8%) did not come for follow-up visits after treatment during pandemic. CONCLUSIONS: The pandemic caused the decrease in number of outpatient STIs consultations and hospitalisations. The proportion of newly diagnosed cases of syphilis per number of consultations increased. The percentage of early syphilis cases, especially early symptomatic syphilis increased. Adherence to after treatment follow up was suboptimal.


Assuntos
COVID-19 , Gonorreia , Infecções por HIV , Minorias Sexuais e de Gênero , Doenças Sexualmente Transmissíveis , Sífilis , Feminino , Gonorreia/diagnóstico , Gonorreia/epidemiologia , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Pandemias , Polônia/epidemiologia , SARS-CoV-2 , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/epidemiologia , Sífilis/diagnóstico , Sífilis/epidemiologia
14.
Rev Esc Enferm USP ; 55: e20200271, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34528992

RESUMO

OBJECTIVE: To analyze, in the light of the social-ecological theory, the temporal progression of gestational syphilis and its relationship with the implementation of the rede cegonha in Ceará. METHOD: This is a retrospective documental study, based on the information system of notifiable diseases about gestational syphilis in the perspective of the social-ecological theory. The sample consisted of all notifications from the state of Ceará in the period from 2007 to 2017. Data collection was carried out in October 2019. RESULTS: A total of 229,558 cases of gestational syphilis was reported in Brazil; of these, 7,040 were from the state of Ceará (3.1%), with a growing increase in cases over the years. Regarding the distribution of syphilis cases between the period before and after the implementation of the rede cegonha, there was an association with education (p < 0.0001), clinical classification (p < 0.0001), and gestational age (p = 0.0005). CONCLUSION: Despite the implementation of public policies and improvement of the epidemiological surveillance system, there is still a long way to go to control syphilis during pregnancy.


Assuntos
Complicações Infecciosas na Gravidez , Sífilis Congênita , Sífilis , Brasil/epidemiologia , Feminino , Idade Gestacional , Humanos , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Estudos Retrospectivos , Teoria Social , Sífilis/epidemiologia , Sífilis Congênita/epidemiologia
15.
BMC Infect Dis ; 21(1): 992, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34556026

RESUMO

BACKGROUND: Syphilis is a sexually transmitted infection that is re-emerging in different parts of the world. This infection can be transmitted during pregnancy, causing neonatal syphilis. The objective of this study was to examine trend in syphilis, congenital syphilis, and neonatal deaths among the Mexican population during 2010-2019. METHODS: An ecological study was carried out to collect information about the incidence of syphilis, the incidence of congenital syphilis, and the incidence of neonatal death from congenital syphilis. The variables were described considering age, sex, Mexican state, and year. Trends across time (calendar year) were analyzed using linear regression, increases were estimated with 95% confidence intervals, and p < 0.05 was considered statistically significant. RESULTS: The incidence of syphilis increased by an average of 0.336 cases/100,000 per year and was higher among women aged 15-19 years (0.693 cases). Cases of congenital syphilis increased from 62 cases in 2010 to 372 cases in 2019; furthermore, the increase in syphilis cases among women aged 20 to 24 years was associated with an increase in cases of congenital syphilis. In 2010, 50% of Mexican states did not report cases of congenital syphilis, but in 2018, only 10% did not report cases of congenital syphilis. Between 2010 and 2018, 83 neonatal deaths were reported, with the highest incidence in 2018 (0.88 deaths/100,000 newborns). CONCLUSION: The incidence of congenital syphilis is increasing in Mexico. As a consequence of the reemergence of syphilis among the population of reproductive age, it is necessary to address and treat syphilis in various population groups.


Assuntos
Doenças Sexualmente Transmissíveis , Sífilis Congênita , Sífilis , Feminino , Humanos , Incidência , Recém-Nascido , México/epidemiologia , Gravidez , Sífilis/epidemiologia , Sífilis Congênita/epidemiologia
17.
Ceska Gynekol ; 86(4): 242-245, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34493048

RESUMO

OBJECTIVE: Description of a case of newborn death after acute caesarean section in 31st week of pregnancy because of mothers syphilitic infection. RESULTS: Fifteen-years-old primigravid woman in 31st week of pregnancy was admitted to a secondary level hospital due to a high risk of preterm labor. The pregnancy was terminated with an acute caesarean section because of pathological cardiotocograph record. The newborn died after 35 min of resuscitation. Blood samples from the umbilical cord and mothers blood taken by her gynecologist were positive for syphilis. In cooperation with a dermatologist, the treatment has been provided and reported to the National Referential Laboratory. The autopsy of the newborn had found severe pneumonia, necrotic lymphadenitis and pyocele. CONCLUSION: The dia-gnosis of congenital syphilis had been determined after the death of a preterm delivered newborn. Resuscitation had no chance to success because of syphilitic damage of the lungs.


Assuntos
Complicações Infecciosas na Gravidez , Sífilis Congênita , Sífilis , Adolescente , Causas de Morte , Cesárea , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Sífilis/diagnóstico , Sífilis Congênita/diagnóstico
18.
J Trop Pediatr ; 67(4)2021 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-34490454

RESUMO

BACKGROUND: Untreated or inadequately treated maternal syphilis infection may be transmitted from mother to child resulting in congenital syphilis (CS) infection. In South Africa (SA), CS is a notifiable medical condition (NMC). The NMC surveillance system (NMCSS) was improved by introducing an electronic notification application, a new case notification form and training resources in July 2017. We describe CS surveillance in SA and report on experiences from implementing an improved NMCSS from August 2017 to December 2019. METHODS: We present the CS case definition, data collected by the CS case investigation and notification forms and data flow through the NMCSS. Descriptive statistics were used to analyse CS notifications received from August 2017 to December 2019. Qualitative inductive analysis of the stakeholder communications diary was conducted to identify CS surveillance challenges. RESULTS: There were 418 CS notifications submitted from 80 facilities in 35 out of 52 districts. Of the notified cases, 194 (46.8%) were male and the median age at notification was 7 days (interquartile range: 3-16 days). The majority were diagnosed in hospital (98.6%). KwaZulu-Natal Province notified the most cases (52.9%) followed by Gauteng (28.0%). Challenges in CS surveillance included the lack of awareness of the CS case definition, completed paper-based notifications not reaching the NMCSS and the limited ability of the system to distinguish improved notifications from increase in disease burden. CONCLUSION: Improved CS surveillance through NMCSS was implemented in SA. Training, support and mentoring on CS and the notification system will be needed to inform elimination efforts.


Assuntos
Doenças Transmissíveis , Sífilis Congênita , Criança , Notificação de Doenças , Feminino , Humanos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Masculino , Mães , Vigilância da População , África do Sul/epidemiologia , Sífilis Congênita/diagnóstico , Sífilis Congênita/epidemiologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-34495265

RESUMO

Syphilis is a chronic bacterial sexually transmitted infectious disease caused by Treponema pallidum. Different age groups are affected by heterogeneous clinical forms of the disease. We report a case of atypical secondary syphilis in an elderly patient with diffuse annular erythematous lesions on the chest, back, upper and lower limbs diagnosed by histopathological, immunohistochemical and serological tests.


Assuntos
Sífilis , Idoso , Humanos , Sífilis/diagnóstico , Treponema pallidum
20.
Artigo em Inglês | MEDLINE | ID: mdl-34495266

RESUMO

Blood transfusion is still an irreplaceable therapeutic modality, widely applied to medical care. Clinical interviews and laboratory testing for transfusion-transmitted infections (TTI) are routinely performed to prevent TTI among the recipients. However, there is still a residual risk of TTI, and some blood banks have adopted the confidential unit exclusion (CUE) as an additional safety strategy. In this study, we investigated the demographic characteristics and laboratory results of the screening of TTI among blood donors who opted for the CUE, compared to blood donors who did not opt for the CUE. In this study, we included 32,261 blood donations collected in a single blood bank in Sao Paulo, Brazil. A very small proportion of donors (0.25%) opted for the CUE. They were mainly single males and were more likely to have HBV, syphilis, and other positive results in the combined screening for TTI, in comparison with those who did not opt for the CUE. This difference was statistically significant in both the univariable and the multivariable analysis adjusted for age, gender , marital status and years of schooling. Our findings highlight that CUE may be a useful tool to improve the safety for blood recipients, but its efficiency is context-dependent.


Assuntos
Doadores de Sangue , Sífilis , Bancos de Sangue , Brasil , Demografia , Humanos , Masculino , Sífilis/diagnóstico
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