Sankaran Deepika, Partridge Elizabeth, Lakshminrusimha Satyan
Division of Neonatology, Department of Pediatrics, University of California Davis, Sacramento, CA 95817, USA.
Division of Infectious Diseases, Department of Pediatrics, University of California Davis, Sacramento, CA 95817, USA.
Children (Basel). 2023 Jul 29;10(8):1310. doi: 10.3390/children10081310.
Congenital syphilis is caused by the spirochete, , which can be transmitted from an infected mother to her fetus during pregnancy or by contact with a maternal lesion at the time of delivery. The incidence of congenital syphilis is rapidly increasing all over world with 700,000 to 1.5 million cases reported annually between 2016 and 2023. Despite the widespread availability of Penicillin, 2677 cases were reported in 2021 in the US. Clinical manifestations at birth can vary widely ranging from asymptomatic infection to stillbirth or neonatal death. Low birth weight, rash, hepatosplenomegaly, osteolytic bone lesions, pseudoparalysis, central nervous system infection, and long-term disabilities have been reported in newborns with congenital syphilis. Prevention of congenital syphilis is multifaceted and involves routine antenatal screening, timely treatment of perinatal syphilis with penicillin, partner tracing and treatment, and health education programs emphasizing safe sex practices and strategies to curb illicit drug use. Neonatal management includes risk stratification based on maternal syphilis history, evaluation (nontreponemal testing, complete blood counts, cerebrospinal fluid, and long-bone analysis), treatment with penicillin, and followup treponemal testing. Public health measures that enhance early detection during pregnancy and treatment with penicillin, especially in high-risk mothers, are urgently needed to prevent future cases of congenital syphilis.
先天性梅毒由梅毒螺旋体引起，可在孕期从受感染母亲传播给胎儿，或在分娩时通过接触母体病损而传播。全球先天性梅毒发病率正在迅速上升，2016年至2023年期间每年报告70万至150万例病例。尽管青霉素已广泛可得，但2021年美国仍报告了2677例病例。出生时的临床表现差异很大，从无症状感染到死产或新生儿死亡。先天性梅毒新生儿已报告出现低出生体重、皮疹、肝脾肿大、溶骨性骨病变、假瘫、中枢神经系统感染和长期残疾。先天性梅毒的预防是多方面的，包括常规产前筛查、用青霉素及时治疗围产期梅毒、追踪和治疗性伴侣，以及开展强调安全性行为和遏制非法药物使用策略的健康教育项目。新生儿管理包括根据母亲梅毒病史进行风险分层、评估（非梅毒螺旋体检测、全血细胞计数、脑脊液和长骨分析）、用青霉素治疗以及后续梅毒螺旋体检测。迫切需要采取公共卫生措施，加强孕期早期检测并用青霉素进行治疗，尤其是对高危母亲，以预防未来的先天性梅毒病例。
