Main Article Content
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
Article Details
Authors who publish in the Jurnal Kedokteran dan Kesehatan Indonesia agree to the following terms:
- Authors retain copyright and grant Jurnal Kedokteran dan Kesehatan Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution Licence that allows others to adapt (remix, transform, and build) upon the work non-commercially with an acknowledgement of the work's authorship and initial publication in Jurnal Kedokteran dan Kesehatan Indonesia.
- Authors are permitted to share (copy and redistribute) the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in Jurnal Kedokteran dan Kesehatan Indonesia.
References
- Hutapea NO. Sifilis. Dalam: Daili SF, Indriatmi W, Zubier F, Judanarso J, penyunting. Infeksi menular seksual. Edisi ke-3. Jakarta: Balai Penerbit; 2005: h. 70-87.
- Domingues RM, Szawarcwald CL, Junior PR, Leal MC. Prevalence of syphilis in pregnancy and prenatal syphilis testing in Brazil: Birth in Brazil study. Rev saude publica. 2014; 48(5): 766-74.
- Efrida. Imunopatogenesis Treponema pallidum dan Pemeriksaan Serologi. Jurnal Kesehatan Andalas. 2014; 3(3): 572–87.
- World Health Organization. Syphilis screening and treatment for pregnant women. Switzerland; 2017: 1-56.
- Korenromp EL, Mahiane SG, Nagelkerke N, Taylor MM, Williams R, Chico RM. Syphilis prevalence trends in adult women in 132 countries – estimations using the spectrum sexually transmited infections model. Sci Rep. 2018; 8(1): 1-10.
- World Health Organization. Report on global sexually transmitted infection surveillance, 2018. Geneva: World Health Organization; 2018. Tersedia dari : apps.who.int /iris/rest/bitstreams/ retrieve. Di unduh 19 April 2020.
- Kinghorn Gr dan Omer R. Syphilis and Congenital Syphilis. Dalam : Griffiths CEM, Barker J, Bleiker T, Chalmers R, Creamer D, penyunting. Rooks Textbook of Dermatology. Edisi ke-9. West Sussex : John Wiley and Sons. 2016: h. 820-52.
- Hitti J, Watts DH. Bacterial Sexually Transmitted Infections in Pregnancy. Dalam: Holmes K, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L dkk, penyunting. Sexually Transmitted Disease. Edisi ke-4. Amerika Serikat: McGraw-Hill; 2008: h.1542-3.
- Imade GE, Musa J, Sagay AS, Kapiga SH, Sankale JL, Idoko J, Kanki P. Association of bacterial vaginosis and other sexually transmitten infections with HIV among pregnant women in Nigeria. Afr J Med Sci. 2014; 43(1): 23-8.
- Katz KA. Syphilis. Dalam: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, David J. Leffell, Wolff K, penyunting. Fitzpatrick's Dermatology in General Medicine volume 2. Edisi ke 9: Amerika Serikat: The McGraw-Hills Companies. 2019: h. 3145-68.
- Gininza TG, Stefan CD, Tsoka-Gwegwenil JM, Dlamini X, Jolly PE, Weiderpass E dkk. Prevalence and risk factors associated with sexually transmitted infections (STIs) among women of reproductive age in Swaziland. Infect Agent Cancer; 2017. 12(29): 1-5.
- Santis M, Luca CD, Mappa I, Spagnuolo T, Licameli A, Straface G, Scambia G. Syphilis infection during pregnancy: Fetal risks and clinical management. Infect Dis Obstet Gynecol. 2012; 2(1): 1-6.
- Korenromp EL, Rowley J, Alonso M, Mello MB, Wijesoorlya S, Mahiane SG dkk. Global burden of maternal and congenital syphilis and associated adverse birth outcomes-estimated for 2016 and progress since 2012. Plos One. 2019; 14(2): 1-17.
- Genc M, Ledger WJ. Syphilis in pregnancy. Sex Transm Inf. 2000; 76(1): 73-9.
- Sparling PF, Swartz MN, Musher DM, Healy BP. Clinical manifestation of syphilis. Dalam: Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L dkk, editor. Sexually Transmitted Disease. Edisi ke-4. Amerika Serikat: McGraw-Hill; 2008: h. 661-84.
- Lynn WA, Lightman S. Review syphilis and HIV syphilis and HIV: A dangerous combination. Lancet Infect Dis. 2004; 4(7): 456–66.
- Kementrian Kesehatan Republik Indonesia. Pedoman Tatalaksana Sifilis untuk Pengendalian Sifilis di Layanan Kesehatan Dasar. Edisi ke-1. Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. Jakarta. 2013: 1-33.
- Tsimis ME, Sheffield JS. Update on syphilis and pregnancy. Birth Defect Res. 2017; 109(1): 347-52.
- Centers for Disease Control and Prevention. Sexually transmitted disease treatment guidelines 2015. MMWR 2015; 64: 34-51.
- Wendel GM Sheffield JS, Hollier LM, Hill JB, Ramsey P, Sanchez PJ. Treatment of syphilis in pregnancy and prevention of congenital syphilis. Clin Infect Dis. 2002; 35(2): 200-9.
References
Hutapea NO. Sifilis. Dalam: Daili SF, Indriatmi W, Zubier F, Judanarso J, penyunting. Infeksi menular seksual. Edisi ke-3. Jakarta: Balai Penerbit; 2005: h. 70-87.
Domingues RM, Szawarcwald CL, Junior PR, Leal MC. Prevalence of syphilis in pregnancy and prenatal syphilis testing in Brazil: Birth in Brazil study. Rev saude publica. 2014; 48(5): 766-74.
Efrida. Imunopatogenesis Treponema pallidum dan Pemeriksaan Serologi. Jurnal Kesehatan Andalas. 2014; 3(3): 572–87.
World Health Organization. Syphilis screening and treatment for pregnant women. Switzerland; 2017: 1-56.
Korenromp EL, Mahiane SG, Nagelkerke N, Taylor MM, Williams R, Chico RM. Syphilis prevalence trends in adult women in 132 countries – estimations using the spectrum sexually transmited infections model. Sci Rep. 2018; 8(1): 1-10.
World Health Organization. Report on global sexually transmitted infection surveillance, 2018. Geneva: World Health Organization; 2018. Tersedia dari : apps.who.int /iris/rest/bitstreams/ retrieve. Di unduh 19 April 2020.
Kinghorn Gr dan Omer R. Syphilis and Congenital Syphilis. Dalam : Griffiths CEM, Barker J, Bleiker T, Chalmers R, Creamer D, penyunting. Rooks Textbook of Dermatology. Edisi ke-9. West Sussex : John Wiley and Sons. 2016: h. 820-52.
Hitti J, Watts DH. Bacterial Sexually Transmitted Infections in Pregnancy. Dalam: Holmes K, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L dkk, penyunting. Sexually Transmitted Disease. Edisi ke-4. Amerika Serikat: McGraw-Hill; 2008: h.1542-3.
Imade GE, Musa J, Sagay AS, Kapiga SH, Sankale JL, Idoko J, Kanki P. Association of bacterial vaginosis and other sexually transmitten infections with HIV among pregnant women in Nigeria. Afr J Med Sci. 2014; 43(1): 23-8.
Katz KA. Syphilis. Dalam: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, David J. Leffell, Wolff K, penyunting. Fitzpatrick's Dermatology in General Medicine volume 2. Edisi ke 9: Amerika Serikat: The McGraw-Hills Companies. 2019: h. 3145-68.
Gininza TG, Stefan CD, Tsoka-Gwegwenil JM, Dlamini X, Jolly PE, Weiderpass E dkk. Prevalence and risk factors associated with sexually transmitted infections (STIs) among women of reproductive age in Swaziland. Infect Agent Cancer; 2017. 12(29): 1-5.
Santis M, Luca CD, Mappa I, Spagnuolo T, Licameli A, Straface G, Scambia G. Syphilis infection during pregnancy: Fetal risks and clinical management. Infect Dis Obstet Gynecol. 2012; 2(1): 1-6.
Korenromp EL, Rowley J, Alonso M, Mello MB, Wijesoorlya S, Mahiane SG dkk. Global burden of maternal and congenital syphilis and associated adverse birth outcomes-estimated for 2016 and progress since 2012. Plos One. 2019; 14(2): 1-17.
Genc M, Ledger WJ. Syphilis in pregnancy. Sex Transm Inf. 2000; 76(1): 73-9.
Sparling PF, Swartz MN, Musher DM, Healy BP. Clinical manifestation of syphilis. Dalam: Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L dkk, editor. Sexually Transmitted Disease. Edisi ke-4. Amerika Serikat: McGraw-Hill; 2008: h. 661-84.
Lynn WA, Lightman S. Review syphilis and HIV syphilis and HIV: A dangerous combination. Lancet Infect Dis. 2004; 4(7): 456–66.
Kementrian Kesehatan Republik Indonesia. Pedoman Tatalaksana Sifilis untuk Pengendalian Sifilis di Layanan Kesehatan Dasar. Edisi ke-1. Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan. Jakarta. 2013: 1-33.
Tsimis ME, Sheffield JS. Update on syphilis and pregnancy. Birth Defect Res. 2017; 109(1): 347-52.
Centers for Disease Control and Prevention. Sexually transmitted disease treatment guidelines 2015. MMWR 2015; 64: 34-51.
Wendel GM Sheffield JS, Hollier LM, Hill JB, Ramsey P, Sanchez PJ. Treatment of syphilis in pregnancy and prevention of congenital syphilis. Clin Infect Dis. 2002; 35(2): 200-9.