Dados do Trabalho

Título

NEUROLOGICAL MANIFESTATIONS OF CONGENITAL SYPHILIS IN EARLY STAGE

Introdução

In pregnant women with VDRL positive and without proper treatment, the incidence of congenital syphilis is 70% to 100%, if it is primary or secondary, and 30% if it is tertiary. Neurological clinical feature occur in up to 40% of cases in late congenital syphilis, not being common in early congenital syphilis, so there are not many studies related to neurological manifestations in early congenital syphilis.

Objetivo

This study aimed to elucidate the possible neurological manifestations resulting from congenital syphilis.

Método

This research included 174 medical records of positive syphilis in pregnants. The analysis was carried out using an Excel table filled with information concerning mother`s and infant`s VDRL titration, as well as the presence or absence of neurological complications in the infant.

Resultados

It was evaluated 172 cases, 13 infants were not included in the analysis due to: six cases of abortion, two cases of intrauterine stillbirth, and five cases due to lack of follow-up. Among the analyzed cases, ages ranking from 5 months to 23 months, 103 children presented positive VDRL, of which three exhibited neurological alterations. An association was observed between maternal low VDRL titers and the occurrence of two cases of plagiocephaly/brachycephaly and a case of generalized tonic-clonic seizures along with absence seizures. Of the 56 children with negative results for VDRL, four presented neurological alterations. One infant, whose mother had low VDRL titers, was diagnosed with Dandy-Walker Syndrome, agenesis of the cerebellar vermis, cyst of the posterior fossa, and hydrocephalus. Another child with a similar history exhibited neuropsychomotor development delay to expected age. A third cases presented multiples malformations with no specification of neurological alterations in mother. The last case, with high maternal VDRL titers, resulted in scaphocephaly, microcephaly, and seizures.

Conclusão

The results highlight an association between maternal VDRL seropositivity and neurological complications in infants, as well as a potential link between low maternal VDRL titers and cranial malformations. However, limitations such as sample size and inadequate case follow-up ask careful interpretation. It is recommended that more extensive studies be conducted and preventive measures during pregnancy be reinforced to mitigate the risk of such complications in infants.

Referências

DOMINGUES, Carmen Silvia Bruniera et al . Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: sífilis congênita e criança exposta à sífilis. Epidemiol. Serv. Saúde, Brasília , v. 30, n. esp1, e2020597, 2021 . Disponível em . acessos em 05 jun. 2024. Epub 28-Fev-2021. http://dx.doi.org/10.1590/s1679-4974202100005.esp1.

Brasil: Ministério da Saúde, Secretaria de Vigilância em Saúde, Programa Nacional de DST/AIDS. Diretrizes para controle da sífilis congênita: manual de bolso. 2ª ed. Brasília: Ministério da Saúde, 2006

Palavras Chave

Syphilis Congenital; Syphilis Serodiagnosis; Infant