Congenital syphilis pathophysiology

Congenital infections Main Page

Congenital syphilis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Congenital Syphilis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Congenital syphilis pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Congenital syphilis pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Congenital syphilis pathophysiology

CDC on Congenital syphilis pathophysiology

Congenital syphilis pathophysiology in the news

Blogs on Congenital syphilis pathophysiology

Directions to Hospitals Treating Congenital syphilis

Risk calculators and risk factors for Congenital syphilis pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Aditya Govindavarjhulla, M.B.B.S. [2] Aravind Kuchkuntla, M.B.B.S[3]

## Overview[edit | edit source]

Pathophysiology of congenital syphilis is still unclear. Several theories have been postulated in regards to the duration of the mother's infection as well as the stage of pregnancy in which infection occurs.

## Pathophysiology[edit | edit source]

### Pahogenesis[edit | edit source]

* Transmission to the fetus is primarily transplacental but it can also occur during delivery in the presence of maternal genital lesions.[1][2][3]
* The risk of transmission to the fetus is dependent on the stage of the maternal disease (dependent on the spirochete concentration in the blood stream) and the duration of exposure to the fetus in utero.[4]
* The risk of vertical transmission of syphilis from an infected untreated mother decreases as maternal disease duration progresses: transmission risk of 70–100% for primary syphilis and 40% for early latent syphilis to 10% for late latent disease. The variation in the percentages with the duration of infection is due to the concentration of spirochetes in the blood stream, which decrease with the duration of maternal syphilis infection.[5]
* Kassowitz's law describes the inverse relationship of interval between the disease and pregnancy. Longer the interval between infection and pregnancy more benign is the outcome.[6]
* Transmission of infection typically takes place between the 16th and 28th week of pregnancy, however the transmission can be as early as the first trimester of pregnancy.[7]

## References[edit | edit source]

1. ↑ Wicher V, Wicher K (2001). "Pathogenesis of maternal-fetal syphilis revisited". Clin Infect Dis. 33 (3): 354–63. doi:10.1086/321904. PMID 11438902.
2. ↑ Domingues RM, Leal Mdo C (2016). "[Incidence of congenital syphilis and factors associated with vertical transmission: data from the Birth in Brazil study]". Cad Saude Publica. 32 (6). doi:10.1590/0102-311X00082415. PMID 27333146.
3. ↑ Peeling RW, Hook EW (2006). "The pathogenesis of syphilis: the Great Mimicker, revisited". J Pathol. 208 (2): 224–32. doi:10.1002/path.1903. PMID 16362988.
4. ↑ Berman SM (2004). "Maternal syphilis: pathophysiology and treatment". Bull World Health Organ. 82 (6): 433–8. PMC 2622860. PMID 15356936.
5. ↑ Genç M, Ledger WJ (2000). "Syphilis in pregnancy". Sex Transm Infect. 76 (2): 73–9. PMC 1758294. PMID 10858706.
6. ↑ Balaji G, Kalaivani S (2013). "Observance of Kassowitz law-late congenital syphilis: Palatal perforation and saddle nose deformity as presenting features". Indian J Sex Transm Dis. 34 (1): 35–7. doi:10.4103/0253-7184.112869. PMC 3730472. PMID 23919053.
7. ↑ Harter C, Benirschke K (1976). "Fetal syphilis in the first trimester". Am. J. Obstet. Gynecol. 124 (7): 705–11. PMID 56895.

Template:WikiDoc Sources