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Boletín Clínico de la Asociación Médica del Hospital Infantil del Estado de Sonora

2023, Number 1

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Bol Clin Hosp Infant Edo Son 2023; 40 (1)

Serological diagnosis of congenital syphilis according to the reverse and traditional algorithm at the Hospital Infantil del Estado de Sonora

Gastélum BMA, Martínez MMÁ, Cano RMA, Dávalos RK, Frías MM

Language: Spanish
References: 11
Page: 7-10
PDF size: 239.90 Kb.


ABSTRACT

Congenital Syphilis (CS) is the transmission of Treponema palidum to the fetus during pregnancy. Its diagnosis is complex, although the cornerstone continues to be serology. The objective of this work is to evaluate the diagnostic utility of traditional and reverse algorithms for CS. Probable cases were defined as: 1) newborn (NB) with clinical signs compatible with CS, b) maternal history of syphilis, and c) reactive maternal serology. The Mother-NB binomial was evaluated with a RPR study and rapid treponemal test (PRT). Subsequently, the cases were classified according to the CDC scenarios modified by the American Academy of Pediatrics (AAP), in which the traditional (AT) and reverse (AR) algorithms are described, which start with taking PRT. The information is presented according to basic statistics. 46 mother-newborn binomials were studied. Only 8.7% of the newborns evaluated met the confirmatory criterion of having 4 times or more the maternal title. The AR was more efficient than the AT, since «very probable and possible» cases were diagnosed in 84%. The 15% false-positive rate with AT may be explained by early syphilis. The pairing of the reactivity of RPR and PRT established syphilitic activity in 78% of the mothers and 54% in the newborns. The implementation of the RA according to the CDC-AAP scenarios was a rapid process that allows the adequa- te classification and treatment of children with CS.


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