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1.
Rev Bras Epidemiol ; 23: e200012, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32130400

RESUMO

INTRODUCTION: Syphilis is a sexually transmitted disease, easy to diagnose and treat, but whose incidence is increasing in Brazil. This study estimated the prevalence of the non-performance of serological tests for syphilis during prenatal care, in addition to evaluating its trend and identifying its associated factors in the municipality of Rio Grande, Rio Grande do Sul, Southern Brazil. METHODS: This is a cross-sectional survey that included all pregnant women living in this municipality who gave birth between January 1 and December 31, 2007, 2010, and 2013. A single standardized questionnaire was administered to the mothers within 48 hours of delivery, while they were still in the maternity ward. We used the χ2 test for proportions and linear trend, and Poisson regression with robust adjustment in the multivariate analysis. The effect measure adopted was prevalence ratio (PR). RESULTS: Among the 7,351 mothers who had at least one prenatal visit, the prevalence of non-performance of serological tests for syphilis in the three years studied was 2.9% (95% confidence interval - 95%CI 2.56 - 3.33), with 3.3% (95%CI 2.56 - 3.97) in 2007, 2.8% (95%CI 2.20 - 3.52) in 2010, and 2.7% (95%CI 2.12 - 3.38) in 2013. Black mothers, those with low household income and schooling, and who had few prenatal visits showed higher PR of non-performance of this test. DISCUSSION: The prevalence of non-performance has virtually not changed in the period, and women with high-risk pregnancy showed a greater probability of not undergoing the test. CONCLUSIONS: This municipality needs to reach mothers with lower socioeconomic status, restructure the local health services, and enhance their operationalization to improve the quality of prenatal care.


Assuntos
Cuidado Pré-Natal/métodos , Sorodiagnóstico da Sífilis/estatística & dados numéricos , Sífilis/diagnóstico , Sífilis/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Análise Multivariada , Distribuição de Poisson , Gravidez , Gravidez de Alto Risco , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
3.
BMC Infect Dis ; 19(1): 1017, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791265

RESUMO

BACKGROUND: Early diagnosis and treatment of neurosyphilis is of great significance for regression. There is no gold standard for the diagnosis of neurosyphilis. We did this study to explore the factors associated with the clinical diagnosis of neurosyphilis and assess their accuracy for the diagnosis of neurosyphilis. METHODS: We retrospectively reviewed 100 cases of syphilis patients who underwent lumbar puncture at a major dermatology hospital in Guangzhou, China between April 2013 and November 2016. Fifty patients who were clinically diagnosed with neurosyphilis were selected as case group. Control group consisted of 50 general syphilis patients who were matched with age and gender. The records of patients were reviewed to collect data of socio-demographic information, clinical symptom, and laboratory indicators. Multivariable logistic regression was used to explore diagnostic indictors, and ROC analysis was used to assess diagnostic accuracy. RESULTS: Neurological symptoms (odds ratio (OR) = 59.281, 95% CI:5.215-662.910, P = 0.001), cerebrospinal fluid (CSF) Treponema pallidum particle agglutination (TPPA) titer (OR = 1.004, 95% CI:1.002-1.006, P < 0.001), CSF protein (OR = 1.005, 95% CI:1.000-1.009, P = 0.041), and CSF white blood cell (WBC) (OR = 1.120, 95% CI:1.017-1.233, P = 0.021) were found to be statistically associated with neurosyphilis. In ROC analysis, CSF TPPA titer had a sensitivity of 90%, a specificity of 84%, and an area under curve (AUC) of 0.941. CONCLUSION: CSF TPPA can potentially be considered as an alternative test for diagnosis of neurosyphilis. Combining with neurological symptoms, CSF protein, CSF WBC, the diagnosis would have a higher sensitivity.


Assuntos
Soronegatividade para HIV , Neurossífilis/diagnóstico , Adulto , Estudos de Casos e Controles , China/epidemiologia , Testes Diagnósticos de Rotina/métodos , Testes Diagnósticos de Rotina/normas , Feminino , Infecções por HIV/líquido cefalorraquidiano , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Neurossífilis/líquido cefalorraquidiano , Neurossífilis/complicações , Neurossífilis/epidemiologia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Sensibilidade e Especificidade , Sífilis/líquido cefalorraquidiano , Sífilis/complicações , Sífilis/diagnóstico , Sífilis/epidemiologia , Treponema pallidum
4.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(12): 1284-1289, 2019 Dec 06.
Artigo em Chinês | MEDLINE | ID: mdl-31795587

RESUMO

Objective: To analyze the status and related factors of adverse pregnancy outcomes in pregnant women with syphilis infection in Guangxi Zhuang Autonomous Region. Methods: A total of 9378 pregnant women with syphilis infection who were diagnosed by Guangxi medical and health care institutions at all levels and were registered in the national "Management information system for mother-to-child transmission of AIDS, syphilis and hepatitis B" . The delivery date of these pregnant women were from 1 January 2014 to 31 December 2018, and their demographic characteristics, treatment, non-treponema pallidum titer, and pregnancy outcomes were collected. Multivariate logistic regression model was used to analyze the related factors of adverse pregnancy outcome. Results: The age of the pregnant women with syphilitic infection was (30.05±6.07) years old. There were 1 184 cases with an adverse pregnancy outcome. The incidence of adverse pregnancy outcome was 12.63%, and 83.30% (7 812 cases) of patients received syphilis treatment, of which 50.32% (3 931 cases) were treated with standard treatment. The results of multivariate analysis showed that, the probability of an adverse pregnancy outcome for a 35-year-old was higher than those of the <25 year old [OR (95%CI)=1.37(1.13-1.67)]. The possibility of the occurrence of an adverse pregnancy outcome in 1-2 times of delivery was lower than that of 0 times of delivery in the past, with the OR (95%CI) value was 0.81 (0.70-0.94). Compared with those who tested for syphilis in the early stages of pregnancy, patients with gestational weeks ≥ 28 weeks of initial examination were more likely to have adverse pregnancy outcomes, with the OR (95%CI) value was 1.54 (1.26-1.88). Compared with the first test titer level was <1:8, the probability of an adverse pregnancy outcome was higher in the titer of ≥1:8, with the OR (95%CI) value was 1.33 (1.12-1.57). There was a higher probability of an adverse pregnancy outcome in the untreated patients compared to the treatment of the syphilitic, with the OR (95%CI) value was 1.41(1.19-1.68). Patients with unregulated treatment were more likely to have adverse pregnancy outcomes than those with standardized treatment, with the OR (95%CI) value was 1.27 (1.09-1.47). Conclusion: Gestational weeks of first examination in pregnant women with syphilis infection, the first test titer, and the treatment condition were closely related to the occurrence of the adverse pregnancy outcome. Pregnant women with syphilis infection without treatment and unstandardized treatment were more likely to have adverse pregnancy outcomes than those of treatment and standardized treatment.


Assuntos
Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Complicações Infecciosas na Gravidez/microbiologia , Resultado da Gravidez/epidemiologia , Sífilis/diagnóstico , Adulto , China/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Sífilis/complicações , Sífilis/epidemiologia
5.
Rev Chilena Infectol ; 36(4): 525-530, 2019 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-31859779

RESUMO

BACKGROUND: Syphilis remains a public health concern worldwide, the accuracy of diagnostic tests is critical for its successful control. Currently, there are two approaches to the diagnosis of syphilis using serological tests: the traditional algorithm and the reverse algorithm. AIM: The goal of this study was to analyse the advantages and disadvantages in the implementation of the syphilis reverse-screening algorithm in an outpatient clinical laboratory. METHODS: An observational cross-sectional study was carried out analyzing 246 reactive sera from a total of 14700 requests for syphilis serology. Chemiluminescent assay ARCHITECT Syphilis TP, V.D.R.L. and FTA-Abs were performed. RESULTS: Among 246 reactive sera by ARCHITECT Syphilis TP, 129 were reactive and 117 were non-reactive by V.D.R.L. the last mentioned resulted in 97 reactive and 20 non-reactive by FTA-Abs, suggesting false positives (0.13%). Two patients with primary infection were detected, that were not detected by V.D.R.L. and one pregnant woman with primary infection with a high value S/CO and V.D.R.L.:1 dils. CONCLUSIONS: Among the advantages of using a reverse algorithm were greater sensitivity in the detection of patients with primary syphilis; automation, complete traceability of the samples; objective interpretation and conclusive results.


Assuntos
Programas de Rastreamento/métodos , Sorodiagnóstico da Sífilis/métodos , Sífilis/diagnóstico , Treponema pallidum/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Estudos Transversais , Feminino , Humanos , Medições Luminescentes , Masculino , Pessoa de Meia-Idade , Gravidez , Sensibilidade e Especificidade , Treponema pallidum/imunologia , Adulto Jovem
6.
Rev. Soc. Odontol. La Plata ; 29(57): 7-9, dic. 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1050645

RESUMO

En la actualidad, la sífilis es una de las patologías infecciosas más frecuentes y diagnosticarla suele ser un gran desafío debido al polimorfismo de su presentación. Es una enfermedad crónica y sistémica, que atraviesa diferentes etapas; el secundarismo sifilítico representa el estadio más florido del proceso, siendo el resultado de la multiplicación y diseminación hematógena y linfática del Treponema pallidum (Tp). Su rápido reconocimiento y correcto tratamiento constituyen una de las principales herramientas para evitar la diseminación. Se describirá un reporte de casos que evidencian las manifestaciones orales de dicha enfermedad, que contribuirán en el diagnóstico oportuno de la misma (AU)


Nowadays, Syphilis is one of the most common infectious diseases. Its diagnosis poses a real challenge to clinicians because of its multiple and different presentations. Syphilis is a chronic and systemic disease that presents different stages. The second stage, usually known as Secondary syphilis is the most florid one due to the reproduction and dissemination of the Treponema pallidum through blood and lymphatic vessels. An accurate and prompt diagnosis and treatment are critical. Two case reports will be described. Both of them show how multiple and different its oral manifestations are, and how they contributed to achieve an early diagnosis (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Manifestações Bucais , Treponema pallidum , Sífilis/diagnóstico , Argentina , Doença Crônica , Assistência Odontológica para Doentes Crônicos
7.
Medicine (Baltimore) ; 98(44): e17744, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689826

RESUMO

Congenital syphilis (CS) can cause serious impact on the fetus. However, congenital syphilis presenting as sepsis is a critical condition but hardly identified by the clinic for the first time. In this study, we aimed to identify the benefit of earlier and accurate diagnosis for the infants who suffer congenital syphilis presenting as sepsis.A retrospective study was performed with patients diagnosed of congenital syphilis presenting as sepsis who were the inpatients in the West China Second Hospital between 2011 and 2018. The control group was collected in the neonatal sepsis patients whose blood culture are positive.Fifty-eight patients were included in the study. In the congenital syphilis group, one patient died and 12 (41.3%) patients get worse to MODS (multiple organ dysfunction syndrome). Symptoms, signs, and lab examinations are found to be significantly different (P < .05) between two groups as below, including rash, palmoplantar desquamation, abdominal distension, splenomegaly, hepatomegaly, etc. And, at the aspect of Hb, PLT, WBC, CRP, ALT, AST, these differences occurred in the different groups. It is obvious that the prognosis of children with syphilis is worse. According to a comparison between the different outcomes in the CS, the worse outcome subgroup of patients is significantly younger and have more severely impaired liver function.Because of the high mortality of these infants, pediatricians should improve awareness of CS. Syphilis screening is recommended for pregnant women.


Assuntos
Sepse Neonatal/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Sepse/diagnóstico , Sífilis Congênita/diagnóstico , Sífilis/diagnóstico , Estudos de Casos e Controles , China , Diagnóstico Diferencial , Diagnóstico Precoce , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Insuficiência de Múltiplos Órgãos/diagnóstico , Insuficiência de Múltiplos Órgãos/microbiologia , Insuficiência de Múltiplos Órgãos/mortalidade , Sepse Neonatal/microbiologia , Sepse Neonatal/mortalidade , Gravidez , Complicações Infecciosas na Gravidez/microbiologia , Complicações Infecciosas na Gravidez/mortalidade , Estudos Retrospectivos , Sepse/microbiologia , Sepse/mortalidade , Sífilis/microbiologia , Sífilis/mortalidade , Sorodiagnóstico da Sífilis , Sífilis Congênita/mortalidade
9.
S Afr Med J ; 109(9): 652-658, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31635589

RESUMO

BACKGROUND: Despite preventive measures and effective treatment, congenital syphilis continues to impact significantly on neonatal morbidity and mortality. There has been no recent South African (SA) published literature reviewing congenital syphilis, particularly in the context of a tertiary neonatal setting. OBJECTIVES: To describe the clinical features of symptomatic neonates with congenital syphilis and to identify modifiable patient, clinical and health facility factors that contributed to syphilis infection. METHODS: All positive serological tests for syphilis performed in neonates at Groote Schuur Hospital (GSH), Cape Town, SA, between 1 January 2011 and 31 December 2013 were obtained. Folders were reviewed, and neonates with clinical signs of congenital syphilis were included. RESULTS: Of 50 symptomatic neonates, 19 (38%) died. Twenty-eight mothers (56%) were unbooked and therefore received no antenatal care. Most mothers (98%) were inadequately treated. Health worker-related failures included poor notification and partner tracing as well as failure to recheck syphilis serology after 32 weeks' gestation in mothers who initially tested negative. Thirty-four neonates required intensive care unit admission. Two significant predictors of mortality were 1-minute and 5-minute Apgar scores <5. Hydrops fetalis was an independent risk factor for mortality, as were moderate to severely abnormal cranial ultrasound scan findings. CONCLUSIONS: Congenital syphilis in neonates admitted to the GSH neonatal unit was associated with substantial morbidity and mortality. The modifiable factors identified represent inadequate antenatal healthcare and health system failures. These factors are longstanding, highlighting the need to establish governance and audit processes and address the continuing socioeconomic and sociocultural barriers that mothers face as a way forward in ultimately eliminating this entirely preventable disease.


Assuntos
Complicações Infecciosas na Gravidez/diagnóstico , Cuidado Pré-Natal/estatística & dados numéricos , Sífilis Congênita/epidemiologia , Sífilis/diagnóstico , Adulto , Índice de Apgar , Feminino , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Masculino , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/microbiologia , Estudos Retrospectivos , África do Sul/epidemiologia , Sífilis/epidemiologia , Sorodiagnóstico da Sífilis , Sífilis Congênita/mortalidade , Centros de Atenção Terciária , Adulto Jovem
10.
Klin Lab Diagn ; 64(9): 546-552, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31610107

RESUMO

The aim of the study was to characterize the dynamics of immunoglobulin IgG and IgM level in syphilis patients serum at different stages of the disease before and after the therapy towards 12 diagnostic antigens of T. pallidum in an microarray assay and to evaluate these data as possible prognostic markers. The dynamics of immunoglobulin IgG and IgM level was measured in the reaction of indirect immunofluorescence using microarray and compared to the results of non-treponemal RPR test and treponemal tests as EIA and reaction of passive hemagglutination. In microarray assay diagnostically high level of IgM in patients with primary, secondary and early latent and late latent syphilis decreased dramatically to zero after the successful therapy. Continuously high level of IgM after the therapy proposes the persistence of infection agents in the organism and points out the need of additional antimicrobial treatment. In most of the cases anti-treponemal IgG level also declined after the successful therapy and this confirms the appropriate treatment. The results of microarray assay coincide with the results of other mentioned laboratory tests for syphilis diagnostics. Microarray assay with the recombinant T. pallidum antigens gives the perspective for creating methods with wider spectrum of diagnostic and therapy control options using the IgM immunoglobulin level as a marker for successful syphilis treatment.


Assuntos
Anticorpos Antibacterianos/sangue , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Sífilis/diagnóstico , Sífilis/tratamento farmacológico , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Sífilis/sangue , Sorodiagnóstico da Sífilis , Treponema pallidum
11.
Turk J Ophthalmol ; 49(5): 297-299, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31650814

RESUMO

We report a patient with unilateral syphilitic intermediate uveitis without dermatological, neurological, or any systemic involvement. He presented to our clinic with complaints of eye floaters and worsening visual acuity in the left eye. He had intermediate uveitis and cystoid macular edema in that eye and both venereal disease research laboratory and microhemagglutination assay for Treponema pallidum serological tests were confirmatory for syphilis. Ocular manifestations of syphilis have variable presentations, and it should be considered when diagnosing unexplained ocular inflammatory diseases, even if the patient's recent history and systemic evaluation are not compatible.


Assuntos
Infecções Oculares Bacterianas/etiologia , Sífilis/complicações , Uveíte Intermediária/etiologia , Acuidade Visual , Anticorpos Antibacterianos/análise , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/microbiologia , Humanos , Macula Lutea/patologia , Masculino , Sífilis/diagnóstico , Sífilis/microbiologia , Tomografia de Coerência Óptica , Treponema pallidum/imunologia , Uveíte Intermediária/diagnóstico , Uveíte Intermediária/microbiologia , Adulto Jovem
12.
Wiad Lek ; 72(9 cz 2): 1844-1850, 2019.
Artigo em Polonês | MEDLINE | ID: mdl-31622277

RESUMO

Infectious diseases are a serious social problem. For several years, there has been an increase in syphilis in Poland. It is an infectious disease and as such is subject to legal regulations. Common (such as all infectious diseases) and detailed statutory regulations apply to syphilis. The subject of the article is the presentation of Polish legal regulations on syphilis as an infectious disease. The specific objective of the article is to present and analyze the doctor's duties regarding the diagnosis (suspicion) of syphilis.


Assuntos
Doenças Transmissíveis/diagnóstico , Notificação de Abuso , Médicos/legislação & jurisprudência , Papel Profissional , Sífilis/diagnóstico , Humanos , Polônia
14.
Rev Soc Bras Med Trop ; 52: e20190044, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618305

RESUMO

We present a case of atypical presentation of secondary syphilis with extensive lymph node involvement and pulmonary lesions, initially suspected as lymphoma. The patient presented with weight loss, dry cough, chest pain, palpable lymph nodes in several peripheral chains, and multiple pulmonary nodules and masses on chest imaging. The key features for secondary syphilis diagnosis were a lymph node biopsy suggestive of reactive lymphadenopathy, positive serologic tests for syphilis, and complete recovery after antisyphilitic treatment.


Assuntos
Pneumopatias/diagnóstico , Linfadenopatia/diagnóstico , Linfoma/diagnóstico , Sífilis/diagnóstico , Adulto , Biópsia , Diagnóstico Diferencial , Humanos , Pneumopatias/microbiologia , Linfadenopatia/microbiologia , Masculino , Sífilis/complicações , Tomografia Computadorizada por Raios X
16.
Medicine (Baltimore) ; 98(36): e17040, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31490394

RESUMO

RATIONALE: Syphilis can share clinical features with autoimmune diseases, such as cutaneous Lupus or rheumatoid arthritis. Moreover, secondary syphilis can have visceral involvement, thus affecting the kidney. Syphilitic nephropathy causes nephrotic syndrome with a classic membranous pattern. We present a unique presentation of a co-infection by syphilis and parvovirus B19 sharing all the biological and histological features of proliferative lupus nephritis (LN). PATIENT CONCERNS: We present a case of a 71-year-old Caucasian male returning from a trip to Asia presenting with nephrotic syndrome with antinuclear antibodies (ANA) positivity. DIAGNOSES: Because of nephrotic syndrome a kidney biopsy was performed. It demonstrated a membranous nephropathy with extracapillary proliferation and a full house pattern (presence of IgA, IgG, IgM and C1Q deposits) on immunofluorescence (IF), highly suggestive of LN class III and V. However, several atypical clinical features notably the age, sex of the patient and the history of travel prompt us to search for another cause of nephropathy. INTERVENTIONS: A serology was positive for syphilis and a PCR in the renal biopsy was also positive for parvovirus B19. Thus, a co-infection by syphilis and parvovirus B19 was funded to be the cause of the renal lesions. OUTCOMES: The proteinuria improved; a course of antibiotic was administrated because of neurologic syphilitic involvement (presence of headache with positive syphilis serology in the CSF). LESSONS: A co-infection by syphilis and parvovirus B19 can share all the biological and histological features of proliferative LN and must be recognized as a cause of pseudo-lupus nephritis.


Assuntos
Eritema Infeccioso/diagnóstico , Nefrite Lúpica/diagnóstico , Sífilis/diagnóstico , Idoso , Coinfecção , Diagnóstico Diferencial , Eritema Infeccioso/complicações , Humanos , Masculino , Sífilis/complicações
17.
Pan Afr Med J ; 33: 90, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489068

RESUMO

Introduction: Syphilis rapid test results may be influenced by numerous environmental and genetic factors. Methods: The proportion of false positive syphilis non-treponemal (NT) and treponemal (T) test results using immuno-chromatographic dual syphilis rapid test on serum from Cameroonian blacks (n=103) versus French blacks (n=104) or French caucasians (n=51), all HIV-negative and free of clinical syphilis, was examined. Results: Black individuals in Cameroon had a significantly higher frequency of false positive NT or T tests than black individuals in France. black individuals in France had a higher frequency of indeterminate NT tests as compared to caucasians in France. Conclusion: Both racial and environmental factors may affect immuno-chromatographic dual syphilis rapid testing.


Assuntos
Antígenos de Bactérias/imunologia , Sorodiagnóstico da Sífilis/métodos , Sífilis/diagnóstico , Treponema pallidum/imunologia , Grupo com Ancestrais do Continente Africano , Camarões , Grupo com Ancestrais do Continente Europeu , Reações Falso-Positivas , França , Humanos , Estudos Prospectivos , Sífilis/imunologia
19.
Indian J Ophthalmol ; 67(9): 1487-1490, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31436209

RESUMO

With a resurgence of syphilis with human immunodeficiency virus (HIV) infection in last few years, various ocular manifestations of syphilis have been described in literature. This case report described an HIV-positive patient on anti-retroviral therapy who was diagnosed and treated for posterior uveitis secondary to ocular syphilis in the recent past presented to our clinic with cystoid macular edema (CME). CME, which did not respond to periocular corticosteroid, resolved with intravitreal sustained release dexamethasone implant. There was a recurrence CME 9 months later and repeat injection of intravitreal implant showed complete resolution. A long-term follow-up did not reveal reactivation of the infection with intravitreal corticosteroid. Intravitreal sustained release dexamethasone implant can be an effective treatment for refractory CME in patients with regressed syphilitic uveitis.


Assuntos
Dexametasona/administração & dosagem , Infecções Oculares Bacterianas/complicações , Edema Macular/tratamento farmacológico , Sífilis/complicações , Adulto , Preparações de Ação Retardada , Implantes de Medicamento , Infecções Oculares Bacterianas/diagnóstico , Seguimentos , Glucocorticoides/administração & dosagem , Humanos , Injeções Intravítreas , Edema Macular/diagnóstico , Edema Macular/etiologia , Masculino , Sífilis/diagnóstico , Tomografia de Coerência Óptica
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