RESUMO
BACKGROUND AND OBJECTIVE: To study the epidemiology, diagnosis, treatment strategies and perinatal outcomes of gestational syphilis. PATIENTS AND METHOD: We performed a retrospective study of 94 pregnant women with syphilis whose gestation and delivery were monitored in a Department of Obstetrics from 2002 to 2010 among a total of 85,806 births of women without syphilis in the same period. RESULTS: The prevalence of gestational syphilis was 0.11%. Most of the women were foreign and the most prevalent type was late latent syphilis. Only 57 patients underwent right treatment despite adequate prescription. Maternal complications were confirmed in 31 pregnant women and 16 cases had fetal complications. We diagnosed 4 cases of neonatal syphilis, 3 of them with syphilitic meningitis, whose mothers had not completed the treatment correctly. CONCLUSIONS: The implementation of a mandatory syphilis serology in the pregnancy has enabled us to diagnose many cases of late latent syphilis. The successful completion of treatment must be ensured to prevent vertical transmission.
Assuntos
Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Complicações Infecciosas na Gravidez/epidemiologia , Sífilis Congênita/prevenção & controle , Sífilis/epidemiologia , Aborto Espontâneo/etiologia , Adolescente , Adulto , África/etnologia , Antibacterianos/uso terapêutico , Ásia/etnologia , Emigrantes e Imigrantes/estatística & dados numéricos , Europa Oriental/etnologia , Feminino , Retardo do Crescimento Fetal/etiologia , Humanos , Pessoa de Meia-Idade , Neurossífilis/etiologia , Neurossífilis/prevenção & controle , Trabalho de Parto Prematuro/etiologia , Penicilina G Benzatina/uso terapêutico , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Resultado da Gravidez , Prevalência , Estudos Retrospectivos , América do Sul/etnologia , Espanha/epidemiologia , Sífilis/diagnóstico , Sífilis/tratamento farmacológico , Sífilis/transmissão , Sorodiagnóstico da Sífilis , Sífilis Latente/diagnóstico , Sífilis Latente/tratamento farmacológico , Sífilis Latente/epidemiologia , Adulto JovemRESUMO
The case of a 45-year old man who presented with a few-hour history of interscapular pain and progressive dificulty walking, in whom a final diagnosis of syphilitic myelitis was made, is reported. This is a rare complication of syphilitic involvement of the Central Nervous System. Its pathological and clinical characteristics are due to vascular impairment, which explains the acute onset and poor prognosis of the disease. The condition should be suspected in cases of acute myelopathy of uncertain etiology.
Assuntos
Pessoa de Meia-Idade , Humanos , Masculino , Mielite/etiologia , Neurossífilis/fisiopatologia , Neurossífilis/prevenção & controleRESUMO
Through information gathered at the statistical and medical register service it was done a descriptive study of some epidemiologic aspects of neurosyphilis at the Juliano Moreira Hospital (Bahia) in a period of 50 years (1930 - 1979). Coeficients of specific mortality were stablished . The distribution of the disease was analyzed according to sex, diagnosis in relation to the year, decades and periods before and after penicilinotherapy . Based on the results it is possible to conclude that: neurosyphilis has a cyclic character in epidemiologic level; women are more resistant or less exposed to the disease; males are more often affected; with the penicilinotherapy it was observed a progressive decrease of mortality; the last death caused by neurosyphilis at the Juliano Moreira Hospital occurred in 1971.