From the Department of Pediatrics, Driscoll Children's Hospital, Corpus Christi, TX.
Department of Dermatology, Driscoll Children's Hospital, Corpus Christi, TX.
Pediatr Infect Dis J. 2022 Jun 1;41(6):e268-e270. doi: 10.1097/INF.0000000000003522. Epub 2022 May 6.
Congenital syphilis represents an important public health challenge in the United States, and its prevalence has been increasing for the past 10 years because of many factors. The diagnosis can be difficult given its various and nonspecific clinical manifestations in newborns, and the possibility of false negative results during prenatal care. The prozone phenomenon, caused by an excess of antibody, which interferes with the regular screening tests, is a cause of false negative tests. This could delay the diagnosis and increase morbidity and mortality in the newborn. We present a case of congenital syphilis in a 3-month-old infant whose mother had prenatal care and negative tests for syphilis, which contributed to the late diagnosis. In the face of clinical findings suggestive of congenital syphilis and negative maternal syphilis tests healthcare providers should consider the possibility of maternal false negative test caused by the prozone phenomenon.
先天性梅毒在美国是一个重要的公共卫生挑战，由于多种因素，其发病率在过去 10 年中一直在上升。由于新生儿临床表现多样且不具特异性，以及产前护理期间可能出现假阴性结果，因此诊断较为困难。由于抗体过多而导致的前带现象会干扰常规筛查试验，从而导致假阴性试验。这可能会延迟诊断并增加新生儿的发病率和死亡率。我们报告了一例 3 个月大婴儿的先天性梅毒病例，其母亲接受了产前护理和梅毒检测均为阴性，这导致了诊断的延误。对于临床表现提示先天性梅毒且母亲梅毒检测为阴性的病例，医务人员应考虑前带现象导致的母体假阴性检测的可能性。
