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C ONGENITAL S YPHILIS. Mom: 21yrs, Am. Ind., Non-Hisp  No regular prenatal care o 1 st visit 11-15-13 o Last visit 1-29-14  4-14-14 presents at small.

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Presentation on theme: "C ONGENITAL S YPHILIS. Mom: 21yrs, Am. Ind., Non-Hisp  No regular prenatal care o 1 st visit 11-15-13 o Last visit 1-29-14  4-14-14 presents at small."— Presentation transcript:

1 C ONGENITAL S YPHILIS

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3 Mom: 21yrs, Am. Ind., Non-Hisp  No regular prenatal care o 1 st visit o Last visit  presents at small hospital for L& D  Dr. notices labial sore, and questions patient  Patient states that the sore “had been there a while” and it wasn’t too painful. Labs Ordered and Results:  – RPR was non reactive  – Gonorrhea+  – Chlamydia and HIV –  – RPR 1:64, TPPA reactive  – CT/GC negative Treatment:  mg Rocephin, 1gm Zith  mU Bicillin Congenital Case #1

4  Born  Healthy weight and length  No congenital deformities  No chancres, rash, or mucosal S/S  unresolved fever  Baby was transferred to NICU at a larger hospital Labs Ordered and Results:  Lumbar puncture – WBC, CBC, protein, glucose all within normal limits. RPR and TPPA non reactive.  Blood draw (non-umbilical) RPR 1:8 TPPA reactive  Long Bone Survey – Normal Treatment:  IV Penicillin 150,000 units/kg/day for 10 days

5 Congenital Case #2 Mom: 16yrs, Am. Ind., Non-Hisp  No early prenatal care  Regular 3 rd trimester care  No vaginal exams  presents for 38 week visit. Labs Ordered and Results:  Chlamydia +, GC –  RPR Non-reactive  Gonorrhea +  Chlamydia and HIV –  RPR 1:256, TPPA reactive Treatment:  gm Zith  mg Rocephin and 1 gm Zith  mU Bicillin  Dr. refers mom for C- section and NICU for baby.  Vaginal exam , prior to C-section, healing lesion seen.

6  Born  Healthy weight and length  No congenital deformities  No chancres, rash, or mucosal S/S Labs Ordered and Results:  Lumbar puncture – WBC, CBC, protein, glucose all within normal limits. RPR and TPPA non reactive.  Blood draw (non-umbilical) RPR 1:8 TPPA reactive  Long Bone Survey - Normal Treatment: IV Penicillin 150,000 units/kg/day for 10 days

7 Congenital Case #3 Mom: 25yrs, White, Non-Hisp  Regular prenatal appointments  No current S/S  No recollection of past S/S  presents for 24 week care Labs Ordered and Results:  RPR 1:64, no TPPA done  RPR 1:128, TPPA reactive  RPR 1:64, TPPA reactive  RPR 1:64, TPPA reactive  Additional labs pending Treatment:  mU Bicillin  mU Bicillin  mU Bicillin Concerns:  Re-infection  Treatment failure

8  Born via C-section  Healthy weight and length  No congenital deformities  No chancres, rash, or mucosal S/S Labs Ordered and Results:  Blood draw (non-umbilical) RPR 1:16, TPPA reactive  Lumbar puncture -- WBC, CBC, protein, glucose all within normal limits. RPR and TPPA non reactive.  Long Bone Survey – consistent with Congenital Syphilis Treatment:  IV Penicillin 200,000 units/kg/day for 10 days

9 (Suspect) Congenital Case #4 Mom: 22yrs, Am. Ind., Non-Hisp  , 1 st prenatal appointment at 12 weeks  “Kissing” lesions & alopecia Labs Ordered & Results:  RPR 1:128, TPPA Reactive  CT +, GC +, HIV - Treatment:  mg Rocephin, 1gm Zith, 2.4 mU Bicillin Fetus:  No heartbeat detected on

10 Is this the end of our Congenital Cases? Amanda Gill M.S. South Dakota Dept. of Health STD Program Manager


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