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Submitted
July 17, 2021
Accepted
May 31, 2022
Published
May 31, 2022
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Abstract

Syphilis is a chronic and systemic sexually transmitted infection caused by Treponema pallidum. The prevalence of syphilis according to the World Health Organization (WHO) is around 12 million cases worldwide and in pregnant women around 1.8 million cases. Syphilis screening in pregnancy is important to break the chain of transmission of congenital syphilis. We reported Mrs. S, 33 years old, 18 weeks pregnant, came with history of itchy patches appeared 8 months ago along with her husband and abortion 1 year ago. The plantar pedis dextra et sinistra showed multiple hyperpigmented macules and no clinical founding in the vagina. Serological tests, reactive Venereal Disease Research Laboratory (VDRL) 1:32, Treponema pallidum hemagglutination (TPHA) >1:5120 and non-reactive human immunodeficiency virus (HIV), support the diagnosis of latent syphilis. Patients were injected with benzathine penicillin 2.4 million units 3 times (1 week apart). Serological test evaluated at months 1, 3 and 6. At month 6, there was a decrease in VDRL value 4 times the initial value, indicating successful therapy in laten syphilis and had received therapy according to the guidelines for late latent syphilis. Syphilis in pregnancy can cause congenital syphilis in the fetus, although latent syphilis has no symptoms. The patient's VDRL titer was reactive in early latent syphilis (>1:8), but based on history and duration of infection more than 1 year including late latent syphilis. Based on this case report, we found that the VDRL titer value did not always correspond to the duration of infection.

Keywords

sexually transmitted infection pregnancy late latent syphilis early latent syphilis

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Author Biographies

Frieda Yanuar, Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi General Hospital, Surakarta

Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi General Hospital, Surakarta

Eka Devinta Novi Diana, Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi General Hospital, Surakarta

Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi General Hospital, Surakarta

Wibisono Nugraha, Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi General Hospital, Surakarta

Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi General Hospital, Surakarta

Ammarilis Murastami, Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi General Hospital, Surakarta

Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi General Hospital, Surakarta

Endra Yustin Ellistasari, Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi General Hospital, Surakarta

Department of Dermatology and Venereology, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi General Hospital, Surakarta

How to Cite
Yanuar, F., Diana, E. D. N., Nugraha, W., Murastami, A., & Ellistasari, E. Y. (2022). Late latent syphilis with early syphilis titer in pregnancy: A case report. JKKI : Jurnal Kedokteran Dan Kesehatan Indonesia, 13(1). https://doi.org/10.20885/JKKI.Vol13.Iss1.art14
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