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1.
Rev. bras. estud. popul ; 39: e0184, 2022. tab, graf
Article in Portuguese | LILACS | ID: biblio-1357048

ABSTRACT

A sífilis, uma infecção vertical e sexualmente transmissível, curável e prevenível, é um problema de saúde pública no Brasil. Métodos diagnósticos e tratamentos são importantes no controle da doença. A pandemia de Covid-19 causou atrasos em diagnósticos e no tratamento na atenção primária em várias doenças e em diversos países, pois interrompeu padrões usuais de atendimento à saúde. O objetivo do estudo é identificar se houve menor número de procedimentos diagnósticos e de tratamento realizados para sífilis nos primeiros sete meses de 2020, comparativamente à média dos mesmos meses entre 2016 e 2019, no Brasil e nas unidades federativas. A redução no número de procedimentos seria um indicativo de atraso no diagnóstico, na detecção e no tratamento da sífilis em 2020. Foram utilizadas informações disponibilizadas no Sistema de Informações Ambulatoriais (SIA/SUS). Os achados para o Brasil indicaram queda de 1/3 nos procedimentos de diagnóstico e de tratamento referentes à sífilis nos sete primeiros meses do ano da pandemia, comparados com a média dos sete primeiros meses nos quatro anos anteriores (2016-2019). Indicadores mostram diferenças importantes por unidades da federação, apontando para maiores quedas proporcionais nos volumes de procedimentos no Norte e Nordeste, com ênfase nos estados do Maranhão, Roraima, Pará, Bahia, Rio Grande do Norte, Amazonas, Pernambuco e Amapá.


Syphilis, a vertical and sexually transmitted infection, curable and preventable, is a public health problem in Brazil. Diagnostic methods and treatments are important in controlling the disease. The COVID-19 pandemic caused delays in diagnosis and lack of treatment in primary care in several diseases and in several countries, as the pandemic disrupted usual health care standards. The aim of the study was to identify whether there were fewer diagnostic and treatment procedures performed for syphilis in the first seven months of 2020, compared to the average for the same months between 2016 and 2019, in Brazil and Federative Units. The reduction in the number of procedures would be indicative of a delay in the diagnosis, detection and treatment of syphilis in 2020. Information used came from the Outpatient Information System (SIA / SUS). The findings for Brazil indicated a 1/3 drop in diagnosis and treatment procedures for syphilis in the first seven months of the year of the COVID-19 pandemic, compared with the first seven months of the previous four years (2016-2019). Indicators showed important differences by Federation Units, pointing to greater proportional decrease in the volume of procedures in the North and Northeast, with an emphasis on Maranhão, Roraima, Pará, Bahia, Rio Grande do Norte, Amazonas, Pernambuco and Amapá.


La sífilis, una infección vertical y de transmisión sexual, curable y prevenible, es un problema de salud pública en Brasil. Los métodos de diagnóstico y los tratamientos son importantes para controlar la enfermedad. La pandemia de Covid-19 provocó retrasos en el diagnóstico y tratamiento en la atención primaria de variadas enfermedades en varios países, ya que interrumpió los estándares habituales de atención de la salud. El objetivo del estudio fue identificar si se realizaron menos procedimientos de diagnóstico y tratamiento de la sífilis en los primeros siete meses de 2020 en comparación con la media de los mismos meses entre 2016 y 2019, en Brasil y en sus unidades federativas. La reducción del número de procedimientos indicaría indicativo de un retraso en el diagnóstico, la detección temprana y el tratamiento de la sífilis en 2020. Para ello se utilizó la información disponible en el Sistema de Información Ambulatoria (SIA/SUS). Los hallazgos indicaron una caída de un tercio en los procedimientos de diagnóstico y tratamiento de la sífilis en los primeros siete meses del año de la pandemia de Covid-19 para Brasil, en comparación con los primeros siete meses de los cuatro años anteriores (2016-2019). Los indicadores mostraron diferencias importantes por unidades de la Federación, apuntando a mayores caídas proporcionales en el volumen de trámites en el Norte y Nordeste, con énfasis en Maranhão, Roraima, Pará, Bahia, Rio Grande do Norte, Amazonas, Pernambuco y Amapá.


Subject(s)
Humans , Unified Health System , Brazil , Syphilis/diagnosis , Diagnostic Techniques and Procedures , Pandemics , Sexually Transmitted Diseases , Fluorescent Treponemal Antibody-Absorption Test , Delivery of Health Care
2.
Rev. Assoc. Med. Bras. (1992) ; 67(7): 991-996, July 2021. graf
Article in English | LILACS | ID: biblio-1346947

ABSTRACT

SUMMARY INTRODUCTION: Congenital syphilis is caused by the vertical transmission of bacteria, Treponema pallidum, from nontreated or inappropriately treated pregnant to the fetus. OBJECTIVE: To evaluate the clinical aspects of Congenital syphilis in Brazil, between 2009-2018. METHOD: It is an analytical cross-sectional study whose data were collected from the Department of Chronical Conditions and Sexually Transmitted Infections of Brazilian Health Ministry. Clinical variables were analyzed using the software Joinpoint Regression, which makes a segmented linear regression. RESULTS: In the study period, 156,969 cases of Congenital syphilis and 1642 deaths by this disease were reported. The trend analysis indicates growing in diagnosis of maternal syphilis during prenatal care, appropriate treatment of pregnant, realization of prenatal care, maternal partner treatment, diagnosis of syphilis in children under seven days, and diagnosis of recent syphilis. CONCLUSIONS: Although the trend analysis presents relative improvement in Congenital syphilis panorama in Brazil, the disease still related to high numbers of evitable perinatal morbidity and mortality. Therefore, the prenatal assistance with quality is fundamental to have a possible change in this field in the country.


Subject(s)
Syphilis, Congenital/epidemiology , Syphilis/diagnosis , Syphilis/epidemiology , Sexually Transmitted Diseases , Brazil/epidemiology , Cross-Sectional Studies
3.
Femina ; 49(2): 102-108, 20210228. tab
Article in Portuguese | LILACS | ID: biblio-1224066

ABSTRACT

Objetivo: Este estudo teve como principal objetivo estimar a prevalência de sífilis gestacional e fatores associados à infecção em uma Maternidade no Sul do Brasil no ano de 2018. Métodos: Trata-se de estudo descritivo, transversal, retrospectivo, no qual foram avaliados os testes rápidos para sífilis de todas as gestantes internadas para atenção ao parto ou ao abortamento na Maternidade Carmela Dutra no ano de 2018. Nos casos confirmados de sífilis, foram obtidos dados epidemiológicos, adequação do tratamento, coinfecção pelo HIV e resultados gestacionais. Resultados: Entre os prontuários analisados, 161 (3,6%) foram considerados casos de sífilis materna. A média de idade das gestantes foi de 27,98 (±6,65), 54 (33,5%) eram primigestas, 114 (70,8%) se declararam brancas, 125 (77,5%) estavam em uma união estável e 85 (52,7%) tinham escolaridade até o ensino médio. Quanto ao tratamento, 71 (44%) trataram de maneira adequada e 90 (56%), de maneira inadequada, e 44 (27,3%) delas realizaram o diagnóstico apenas no momento da internação hospitalar. Entre as pacientes que realizaram tratamento inadequado de sífilis, 28 (53,4%) apresentaram títulos iguais ou superiores a 1:8. Entre as pacientes que realizaram teste rápido para HIV na internação, 5 (3,7%) apresentaram coinfecção com a doença. Com relação ao tratamento dos parceiros no pré-natal, 11,8% não realizaram nenhum tipo de tratamento, porém em 66 (41%) prontuários não constava essa informação. Com relação ao desfecho neonatal, 5 (7,4%) pacientes com tratamento inadequado para sífilis tiveram parto prematuro, 5 (7,4%) recém- -nascidos foram de baixo peso e 22 (24,5%) pacientes apresentaram abortamento da gestação. Conclusão: A alta taxa de tratamentos inadequados sugere falhas na assistência pré-natal e indica serem necessárias novas estratégias para reduzir a transmissão de sífilis na gestação.(AU)


Objective: The aim of this study is to estimate the prevalence of maternal syphilis and factors associated with the infection in Carmela Dutra Maternity in 2018. Methods: This is a descriptive, cross-sectional and retrospective study. All of the syphilis rapid- tests on pregnant women admitted for childbirth or miscarriage assistance at Carmela Dutra Maternity in 2018 were avaluated. In the cases of confirmed syphilis infection, the variables were epidemiological data, adequacy of treatment, HIV coinfection and gestational outcomes. Results: Out of all the medical records analyzed, 161 (3.6%) were considered maternal syphilis (MS). The average age of the pregnant women was 27.98 (± 6.65), 54 (33.5%) were primigestae, 114 (70.8%) declared themselves white, 125 (77.5%) were in a stable relationship and 85 (52.7%) had a high school education. Regarding treatment, 71 (44%) were treated adequately and 90 (56%) inadequately. Forty-four (27.3%) were diagnosed only at the time of hospitalization. Amongst patients who had inadequate syphilis treatment, 28 (53.4%) had titers equal to or greater than 1:8. Amongst patients who underwent rapid HIV testing during hospitalization, 5 (3.7%) had HIV coinfection. Regarding the partners treatment during prenatal, 11.8% did not receive any treatment, but 66 (41%) of the medical records did not contain this information. Regarding neonatal outcome, 5 (7.4%) of patients with inadequate treatment for syphilis had premature birth, 5 (7.4%) of newborns were underweight and 22 (24.5%) had miscarriages. Conclusion: The high rate of inadequate treatment suggests failure in prenatal care and indicates that new strategies are necessary to reduce syphilis transmission during pregnancy.(AU)


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/epidemiology , Syphilis/diagnosis , Syphilis/epidemiology , Penicillins/therapeutic use , Prenatal Care/statistics & numerical data , Brazil/epidemiology , Syphilis/drug therapy , Medical Records , Cross-Sectional Studies
4.
Article in English | WPRIM | ID: wpr-921877

ABSTRACT

Objective To analyze the reasons of misdiagnosis of primary syphilitic chancre and strengthen the understanding of atypical features of this disease. Methods A case series of twenty-seven challenging primary syphilis patients who were not immediately recognized as chancre was included in our study. The clinical data including the patients' age, sex, skin lesions, HIV status, syphilis serologic test results, treatment, and follow-up results were collected. Hematoxylin-eosin and immunohistochemistry staining of skin biopsy sections were reviewed. Results Four female cases with extragenital chancres presenting as erythema or erosive skin lesions on the nipple were misdiagnosed as Paget's disease or eczema. The disorder of missed or misdiagnosed male cases manifested as syphilitic balanitis or multiple chancres on the penis root and adjacent pubis rather than coronal sulcus or frenum. Patients with nonreactive nontreponemal tests at initial presentation were also easily missed or misdiagnosed. Conclusion Primary syphilis presenting as multiple lesions rather than a single chancre, at atypical locations, or with a nonreactive nontreponemal test result, tends to be missed or misdiagnosed.


Subject(s)
Chancre/diagnosis , Female , Humans , Male , Nipples , Skin , Syphilis/diagnosis
5.
Article in English | WPRIM | ID: wpr-878357

ABSTRACT

Objective@#The aim of the present study was to evaluate the performance of the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA using one dried blood spot (DBS) as an alternative sample to plasma.@*Method@#A total of 571 paired DBS/plasma samples were collected from men who have sex with men (MSM) and injection drug users (IDUs), and serological and molecular assays were performed. Using plasma results as the reference standard, the performance of DBS tests for HIV-1 RNA, HIV-1 DNA, and HCV RNA was evaluated. Pearson's correlation coefficients and Bland-Altman analysis were performed to assess the correlation and concordance between DBS and plasma.@*Results@#Among paired plasma/DBS samples with detectable HIV-1 RNA and HCV RNA, five samples (5/32) were not detectable in DBS, while measurable HIV-1 RNA levels were present in plasma (1.44 to 3.99 log @*Conclusion@#The performance of the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA using one DBS was acceptable. DBS, as an alternative sample to plasma, may be a viable option for the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA in resource-limited settings or for individuals living in areas that are difficult to access.


Subject(s)
DNA, Viral/analysis , Diagnostic Tests, Routine/methods , Dried Blood Spot Testing/methods , HIV Infections/diagnosis , HIV-1/isolation & purification , Hepacivirus/isolation & purification , Hepatitis C/diagnosis , RNA, Viral/analysis , Sensitivity and Specificity , Specimen Handling/methods , Syphilis/diagnosis , Treponema pallidum/isolation & purification
6.
Rev. bras. oftalmol ; 80(4): e0025, 2021. graf
Article in English | LILACS | ID: biblio-1288629

ABSTRACT

ABSTRACT Syphilis is a sexually transmitted infection caused by the spirochete Treponema pallidum. Ocular involvement can occur at any time, and it may affect 10% of patients in the secondary stage, and from 2% to 5% in the tertiary stage. Uveitis is the most common presentation of ocular syphilis, affecting 0.4% to 8% of patients with systemic disease. Chorioretinitis is the most common posterior alteration. We present the case of a 53-year-old male patient, presenting with bilateral low visual acuity and nyctalopia for 3 years. His physical examination revealed decreased pupillary reflex, anterior vitreous cells, physiologic papillae, arteriolar attenuation, reduced foveal reflex, diffuse retinal pigment epithelium atrophy, peripapillary and perivascular punctate pigment accumulation and peripheral chorioretinitis. Full-field electroretinogram was extinct in both eyes. Treponemal syphilis test was positive. Previously diagnosed as retinitis pigmentosa, evolved to blindness, despite proper treatment. Our case shows syphilis as a significant cause of blindness. Atypical presentations of retinitis pigmentosa must warn ophthalmologists to etiologies of pseudoretinitis pigmentosa, such as syphilis.


RESUMO A sífilis é uma infecção sexualmente transmissível causada pela espiroqueta Treponema pallidum. A sífilis ocular pode ocorrer em qualquer estágio da doença, chegando a 10% na forma secundária e a 2% a 5% em sua forma terciária. A uveíte é a manifestação ocular mais comum, ocorrendo em 0,4% a 8% dos pacientes com a doença sistêmica. A coriorretinite é a manifestação mais comum do segmento posterior. Apresentamos o caso de um paciente do sexo masculino, 53 anos, com queixa de baixa acuidade visual e nictalopia há ٣ anos. Seu exame físico revelou lentificação dos reflexos pupilares, celularidade no vítreo anterior, papilas fisiológicas, atenuação arteriolar, redução do reflexo foveal, atrofia difusa do epitélio pigmentar da retina, acúmulo punctato de pigmento em regiões peripapilar e perivascular e coriorretinite periférica. Eletrorretinograma de campo total extinto em ambos os olhos. O teste treponêmico foi positivo. Foi previamente diagnosticado como portador de retinose pigmentar, evoluindo com cegueira, a despeito do tratamento correto instituído. Esse caso mostra a sífilis como importante causadora de cegueira. Casos atípicos de retinose pigmentar devem alertar o oftalmologista para causas de pseudorretinose pigmentar, como a sífilis.


Subject(s)
Humans , Male , Middle Aged , Retinal Diseases/etiology , Syphilis/complications , Retinitis Pigmentosa/etiology , Retinal Diseases/diagnosis , Ceftriaxone/therapeutic use , Syphilis Serodiagnosis/methods , Fluorescein Angiography , Syphilis/diagnosis , Syphilis/drug therapy , Visual Acuity , Uveitis, Posterior/diagnosis , Uveitis, Posterior/etiology , Retinitis Pigmentosa/diagnosis , Blindness/etiology , Tomography, Optical Coherence , Electroretinography , Fundus Oculi
7.
Audiol., Commun. res ; 26: e2496, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1350159

ABSTRACT

RESUMO Objetivo Avaliar os achados audiológicos de recém-nascidos expostos à sífilis materna, tratada adequadamente na gestação. Métodos Estudo de coorte única não concorrente, realizado em um hospital público. Fizeram parte da amostra recém-nascidos filhos de mães que apresentaram sorologia positiva para sífilis e que realizaram o tratamento adequado durante a gestação, compondo o grupo estudo, e recém-nascidos sem indicadores de risco para deficiência auditiva, grupo comparação. Resultados Participaram do estudo 90 recém-nascidos, sendo 41 do grupo estudo e 49 do grupo comparação. No exame de emissões otoacústicas por estímulo transiente, todos apresentaram presença de resposta bilateralmente e, na comparação das amplitudes de respostas nas bandas de frequências de 3,0 kHz, 3,5 kHz e 4,0 kHz observou-se menor amplitude de resposta no grupo exposto, com diferença estatisticamente significativa para a frequência de 4 kHz à direita. Na análise das respostas do exame de potencial evocado auditivo de tronco encefálico, não se observou assimetria de resposta entre as orelhas que sugerisse alteração retrococlear e nem diferenças nos valores das latências absolutas ou intervalos interpicos, entre os grupos. Conclusão As respostas eletroacústicas foram discretamente inferiores nos recém-nascidos exposto à sífilis materna, enquanto que as respostas eletrofisiológicas foram semelhantes às encontradas na população de baixo risco para deficiência auditiva.


ABSTRACT Purpose To evaluate the audiological findings of newborns exposed to maternal syphilis, properly treated during pregnancy. Methods This was a single, non-concurrent cohort study conducted in a public hospital. The sample included newborns whose mothers had positive syphilis serology and who underwent adequate treatment during pregnancy, composing the study group, and newborns without risk indicators for hearing loss, as a comparison group. Results Ninety newborns participated in the study, 41 were the study group and 49 were the comparison group. In the transient evoked otoacoustic emissions test, all newborns showed a bilateral response, and when comparing the amplitudes of responses in the 3.0 kHz, 3.5 kHz and 4.0 kHz frequency bands, a smaller amplitude of response in the studied group with a statistically significant difference for the frequency of 4 kHz on the right was observed. An analysis of the response of the brainstem auditory evoked potential test showed no asymmetry of response between the ears that suggest a retrocochlear alteration, nor difference in the values of absolute latencies or interpeak intervals between groups. Conclusion The electroacoustic responses were slightly lower in newborns exposed to maternal syphilis, whereas their electrophysiological responses were similar to those found in the population at low risk for hearing loss.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Syphilis/diagnosis , Risk Factors , Pregnant Women , Hearing Tests/methods , Syphilis, Congenital/prevention & control , Evoked Potentials, Auditory , Hearing Loss , Antitreponemal Agents
8.
Article in English | LILACS | ID: biblio-1283958

ABSTRACT

Introduction: There is a need for studies to know the real situation and outline measures to guarantee a reduction in the rates of pregnant women diagnosed with HIV, Syphilis and Toxoplasmosis. Objective: To determine the prevalence of Syphilis, HIV and toxoplasmosis in puerperal women assisted at the largest public maternity hospital in Campos dos Goytacazes in 2016. Methods: Cross-sectional study, using secondary data from the puerperal women assisted at the largest maternity hospital in the northern region of the State of Rio de Janeiro, in the year 2016. Results: There were 970 puerperal women, with a prevalence of HIV, Syphilis and Toxoplasmosis in pregnancy of 1.6, 2.7 and 2%, respectively. Most pregnant women were diagnosed at delivery due to low serological coverage during pregnancy. Conclusion: The high prevalence of Syphilis, HIV and Toxoplasmosis in pregnancy requires efficient prenatal care for its identification and approach.


Introdução: São necessários estudos para conhecer a real situação e delinear medidas que garantam a redução dos índices de gestantes com diagnóstico de vírus da imunodeficiência humana, sífilis e toxoplasmose. Objetivo: Determinar a prevalência de sífilis, vírus da imunodeficiência humana e toxoplasmose em puérperas atendidas na maior maternidade pública de Campos dos Goytacazes (RJ) no ano de 2016. Métodos: Estudo transversal, utilizando dados secundários das puérperas atendidas na maior maternidade do Norte Fluminense no ano de 2016. Resultados: Foram 970 puérperas, com prevalência de vírus da imunodeficiência humana, sífilis e toxoplasmose na gestação de 1,6, 2,7 e 2%, respectivamente. A maioria das gestantes foi diagnosticada no momento do parto em razão da baixa cobertura sorológica durante a gestação. Conclusão: A alta prevalência de sífilis, vírus da imunodeficiência humana e toxoplasmose na gravidez requer um pré-natal eficiente para sua identificação e abordagem.


Subject(s)
Humans , Female , Pregnancy , Adult , Young Adult , Syphilis/diagnosis , HIV Infections/diagnosis , Toxoplasmosis/diagnosis , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Prenatal Diagnosis , Socioeconomic Factors , Syphilis/epidemiology , HIV Infections/epidemiology , Toxoplasmosis/epidemiology , Prevalence , Cross-Sectional Studies
9.
Rev. Soc. Bras. Med. Trop ; 54(supl.1): e2020549, 2021. graf
Article in English | LILACS | ID: biblio-1250847

ABSTRACT

Abstract This article summarizes the chapter on epidemiological surveillance of sexually transmitted infections (STI) that comprises the 2020 Clinical Protocol and Therapeutic Guidelines (PCDT) for Comprehensive Care for People with STI, published by the Health Surveillance Department of the Brazilian Ministry of Health. It presents some reflections on the new case definitions for surveillance of acquired syphilis, syphilis in pregnant women, and congenital syphilis. The 2020 PCDT-IST was elaborated grounded on scientific evidence and validated in discussions with specialists. Epidemiological and clinical aspects are addressed, and health service managers' guidelines regarding programmatic and operational management of these diseases are presented. Guidelines for health professionals on screening, diagnosing, and treating people with STI and their sex partners, in addition to strategies for surveillance, prevention, and control actions, are also published.


Subject(s)
Humans , Female , Pregnancy , Child , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Syphilis, Congenital , Syphilis/diagnosis , Syphilis/epidemiology , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/prevention & control , Sexually Transmitted Diseases/epidemiology , Brazil/epidemiology
10.
Rev. Soc. Bras. Med. Trop ; 54(supl.1): e2020597, 2021. graf
Article in English | LILACS | ID: biblio-1250846

ABSTRACT

Abstract The topics of congenital syphilis and children exposed to syphilis compose the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. Such document was elaborated based on scientific evidence and validated in discussions with specialists. This article provides guidelines for syphilis in pregnant women and congenital syphilis clinical management, emphasizing the vertical transmission of Treponema pallidum prevention. Epidemiological and clinical aspects of these infections are presented and recommendations for managers in the programmatic and operational management of syphilis. The article also includes guidelines for health professionals in screening, diagnosing, and treating people with sexually transmitted infections and their sex partners, in addition to strategies for surveillance actions, prevention, and control of the disease.


Subject(s)
Humans , Female , Pregnancy , Child , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/prevention & control , Syphilis, Congenital/diagnosis , Syphilis, Congenital/prevention & control , Syphilis/diagnosis , Syphilis/epidemiology , Syphilis/diagnostic imaging , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/prevention & control , Brazil/epidemiology
11.
Rev. Soc. Bras. Med. Trop ; 54(supl.1): e2020630, 2021. graf
Article in English | LILACS | ID: biblio-1250840

ABSTRACT

Abstract The recommendations for diagnostic tests for investigating syphilis are part of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections and the Technical Manual for Syphilis Diagnosis, published by the Brazilian Ministry of Health. These recommendations were developed based on scientific evidence and discussions with a panel of experts. This article presents direct tests to detect Treponema pallidum in lesions and algorithms that combine treponemal and non-treponemal antibody tests to assist in syphilis diagnosis, with the aim of contributing to the efforts of health service managers and health professionals in qualifying health care. The article also covers the use of non-treponemal tests to investigate neurosyphilis and guidelines for interpreting non-treponemal antibody titers in monitoring the treatment and diagnosis of congenital syphilis, as well as prospects for innovations in diagnosis. The critical role of rapid immunochromatographic treponemal tests for public health and for addressing syphilis is also highlighted.


Subject(s)
Humans , Syphilis/diagnosis , Sexually Transmitted Diseases , Brazil , Syphilis Serodiagnosis , Diagnostic Tests, Routine
12.
Medicina (B.Aires) ; 80(6): 714-717, dic. 2020. graf
Article in Spanish | LILACS | ID: biblio-1250300

ABSTRACT

Resumen La sífilis maligna asociada al virus de la inmunodeficiencia humana (HIV). Se presenta con lesiones nodulares cutáneas con tendencia a la ulceración. Entre sus hallazgos histopatológicos se destaca la presencia de granulomas no caseificantes, lo cual obliga al diagnóstico diferencial con otras patologías granulomatosas infecciosas y no infecciosas. La evolución de la enfermedad es favorable con el tratamiento con penicilina en la mayoría de los casos. Presentamos el caso de una paciente con infección por HIV que cumple criterios diagnósticos de sífilis maligna y alertamos sobre esta entidad granulomatosa poco frecuente.


Abstract Malignant syphilis occurs frequently in patients infected with human immunodeficiency virus (HIV) and presents with cutaneous nodular lesions that tend to ulcerate. Non caseating granulomas are among the most conspicuous histopathological findings and require differential diagnosis with other infectious and non-infectious granulomatous conditions. The evolution of the disease is usually favourable with penicillin treatment. We present the case of an HIV-positive patient who meets diagnostic criteria for malignant syphilis and alert on this infrequent granulomatous entity.


Subject(s)
Humans , Syphilis/complications , Syphilis/diagnosis , Syphilis/drug therapy , HIV Infections/complications , HIV Infections/diagnosis , Administration, Cutaneous , Diagnosis, Differential , Granuloma
13.
An. bras. dermatol ; 95(5): 589-593, Sept.-Oct. 2020. graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1130950

ABSTRACT

Abstract Background: Syphilis is one of the most common diseases that start with genital ulcers. Aside from the initial, classic ulcerative lesion of syphilis, called hard chancre, atypical presentations are common, with erosions, erythema, edema, balanitis, and other dermatological manifestations. Associated with initial genital lesions, the presence of inguinal adenopathies is frequent, and the presence of hardened and painless lymphangitis on the dorsum of the penis is rare. Objectives: To describe atypical penile manifestations in patients with early syphilis. Methods: The present study reports patients who developed cord-like lesions on the penis. Results: The study included 25 patients with cord-like lesions on the penis; in 19 of those, the diagnosis of syphilis was confirmed. Study limitations: Small number of patients included. Conclusions: In view of the findings of the present investigation, it is important to emphasize that all patients who present with cord-like lesions on the penis must undergo a rapid test for syphilis, VDRL, serologies for HIV viral hepatitis B and C and, whenever possible, histopathological and Doppler exams.


Subject(s)
Humans , Male , Balanitis , Syphilis/diagnosis , Hepatitis B , Penis , Edema
14.
Femina ; 48(9): 563-567, 20200930. graf, tab
Article in Portuguese | LILACS | ID: biblio-1122585

ABSTRACT

A sífilis é uma doença infectocontagiosa, causada pelo Treponema pallidum e transmitida sexual e verticalmente durante a gestação. Essa doença acomete praticamente todos os órgão e sistemas, e, apesar de ter tratamento eficaz e de baixo custo, vem se mantendo como problema de saúde pública até os dias atuais, devido ao tratamento inadequado. Neste estudo, realizado em Juiz de Fora, Minas Gerais, no período entre 2010 e 2017, observou-se uma correlação entre o fator etário e educacional na contração da sífilis em gestantes, visto que 34,62% das gestantes acometidas pela doença estão na faixa etária entre 20 e 24 anos, e 86,88% delas possuem apenas ensino fundamental e médio. Dessa forma, podemos concluir que uma baixa formação acadêmica e a faixa etária jovem adulta são fatores que colaboram para uma maior incidência de sífilis nessas mulheres.(AU)


Syphilis is an infectious disease, caused by Treponema pallidum and transmitted sexually and vertically during pregnancy. This disease affects practically all organs and systems, and, despite having effective and low-cost treatment, it has remained a public health problem until today, due to inadequate treatment. In this study conducted in Juiz de Fora, Minas Gerais, between 2010 and 2017, there was a correlation between the age and educational factor in the contraction of syphilis in pregnant women, since 34.62% of pregnant women affected by the disease are in the age group between 20 and 24 years old and 86.88% of them have only elementary and high school education. Thus, we can conclude that a low academic background and the young adult age group are factors that interfere in a higher incidence of syphilis in these women.(AU)


Subject(s)
Humans , Female , Pregnancy , Syphilis/diagnosis , Syphilis/epidemiology , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Risk Factors
15.
Ciênc. Saúde Colet ; 25(8): 2949-2960, Ago. 2020. tab, graf
Article in English, Portuguese | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1133106

ABSTRACT

Resumo Objetivou-se analisar a tendência temporal da incidência de sífilis congênita (SC) e caracterizar a doença no estado de Minas Gerais (MG) entre 2007 e 2015. Estudo quantitativo, de análise de série temporal, com banco de dados do Sistema de Informação de Agravos de Notificação, referentes aos casos de SC notificados em MG entre 2007 e 2015. Utilizou-se estatística descritiva, cálculo da taxa de incidência de SC e modelo de regressão polinomial para análise de tendência temporal. Os resultados mostraram que no período registraram-se 4.381 casos. A taxa de incidência variou entre 0,61 e 5,08/1.000 nascidos vivos (NV), com incremento na tendência temporal do coeficiente de incidência da SC no período de 2007 a 2015, com variação anual da taxa de 30,6% (IC95%: 21,0 - 41,0). Houve predomínio de recém-nascidos de cor de pele parda (38,7%), faixa etária de até 6 dias de vida (94,7%) e a maioria (63,6%) não apresentou, em relação ao exame físico, qualquer manifestação sugestiva de SC, porém teve diagnóstico definitivo para SC recente (95,2%). O número de casos notificados é crescente, sugerindo que há uma necessidade de melhoria na assistência ao pré-natal, diagnóstico, tratamento adequado, ações de saúde e notificação.


Abstract The objective was to analyze the temporal trend of the incidence of congenital syphilis (CS) and to characterize the disease in the state of Minas Gerais (MG) between 2007 and 2015. Quantitative study, of a time series analysis, with the database from the Information System of Diseases Notification, referring to cases of CS reported in MG between 2007 and 2015. It was used descriptive statistics, calculation of the incidence rate of CS and polynomial regression model for temporal trend analysis. The results showed that in the period 4,381 cases were registered. The incidence rate ranged from 0.61 to 5.08 per 1,000 live births (LB),with an increase in the temporal trend of the CS incidence coefficient in the period from 2007 to 2015, with an annual rate variation of 30.6% (95% CI: 21.0 - 41.0). There was a predominance of brown-skinned newborns (38.7%), up to 6 days old (94.7%) and the majority (63.6%) did not present any suggestive manifestations of CS, but definitive diagnosis for recent CS (95.2%). The number of reported cases is increasing, suggesting that it is necessary, for improvement in the prenatal care, diagnosis, appropriate treatment, health care and notification.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Syphilis, Congenital/epidemiology , Syphilis/diagnosis , Syphilis/epidemiology , Prenatal Care , Brazil/epidemiology , Incidence , Disease Notification
16.
Rev. méd. Chile ; 148(7): 956-962, jul. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1139397

ABSTRACT

Background: Syphilis continues to be a common sexually transmitted disease. Aim: To describe the epidemiologic features of patients with syphilis consulting in a Chilean sexually transmitted diseases clinic. Material and Methods: Review of medical records of patients with positive serology for syphilis, who attended a unit of sexually transmitted diseases between 2015 and 2017. Results: Of 266 cases, 61% were male and 74% were aged between 20 and 49 years. The highest incidence was observed in males aged between 20 and 30 years. Eighty five percent of cases were diagnosed in latent phases, 10% of the cases had a co-infection with HIV and 18%, a history of other sexually transmitted disease. The rate of coinfection was significantly higher in men than in women (78 and 28%, respectively; p < 0.01). Only 6.4% reported always using a condom. Men used it with higher frequency than women (72 and 28% respectively; p < 0.01). A low adherence to treatment and faulty follow-up and treatment of sexual contacts was observed. Twenty five percent of women diagnosed with syphilis were pregnant and 27% of them had a premature birth, with one neonatal death. Conclusions: A high incidence of syphilis was observed, especially in men of younger ages. The diagnosis is delayed, the treatment of sexual contacts and the use of condoms are uncommon. Although the treatment of pregnant women is appropriated, some perinatal complications are observed.


Subject(s)
Humans , Male , Female , Pregnancy , Adult , Middle Aged , Young Adult , Syphilis/diagnosis , Syphilis/epidemiology , Chile/epidemiology , Ambulatory Care Facilities
17.
Prensa méd. argent ; 106(4): 208-212, 20200000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1367972

ABSTRACT

La sífilis desde hace siglos desafía a la humanidad, es transmitida por vía sexual y verticalmente durante la gestación.9 Esta enfermedad se hizo conocida en Europa a finales del siglo XV,13 y su rápida propagación por todo el continente la transformó en una de las principales plagas mundiales.Era preocupante el crecimiento de la endemia sifilítica en el siglo XIX 13.1. En contrapartida la medicina se desarrollaba, y la síntesis de las primeras drogas se hacía realidad. El mayor impacto tal vez fue la introducción de la penicilina en 1946, la cual por su eficacia hizo a muchos pensar que la enfermedad estaba controlada. En un estudio de revisión de literatura se dice que a raíz de la introducción de la penicilina la incidencia de sífilis (y de uveítis sifilítica) fue disminuyendo constantemente hasta finales de los años 90.3 resultando en la disminución del interés por su estudio y control. Con la aparición del síndrome de inmunodeficiencia adquirida (SIDA).2 se incrementó dramáticamente la evolución de esta enfermedad.En la literatura oftalmológica se comenzaron a documentar cada vez más casos e incluso se ha llegado a hablar de la «nueva epidemia de sífilis ocular¼1 Se estima que, anualmente, unos 357 millones de personas contraen alguna de las cuatro infecciones de transmisión sexual (ITS) siguientes: clamidias, gonorrea, sífilis o tricomoniasis.7 En el mundo hay una incidencia anual de aproximadamente 12 millones de pacientes con sífilis el 90% ocurre en países en desarrollo (OMS).


Syphilis has defied humanity for centuries, is transmitted sexually and vertically during pregnancy. This disease became known in Europe at the end of the 15th century,13 and its rapid spread throughout the continent transformed it into one of the main world plagues. The growth of the syphilitic endemic in the 19th century was worrisome.13.1 In contrast, medicine developed, and the synthesis of the first drugs became a reality. Perhaps the biggest impact was the introduction of penicillin in 1946, which, due to its effectiveness, led many to believe that the disease was controlled. In a literature review study, it is said that following the introduction of penicillin the incidence of syphilis (and syphilitic uveitis) was steadily decreasing until the end of the 90s.3 resultando in the decrease of interest in its study and control. With the onset of acquired immunodeficiency syndrome (AIDS). the evolution of this disease increased dramatically. In the ophthalmological literature, more and more cases have been documented and there has even been talk of the "new epidemic of ocular syphilis".1.1 It is estimated that some 357 million people each year get one of the four sexually transmitted infections (STIs) following: chlamydia, gonorrhea, syphilis or trichomonas's. In the world there is an annual incidence of approximately 12 million patients with syphilis 90% occurs in developing countries (WHO)


Subject(s)
Humans , Female , Adult , Penicillins/administration & dosage , Penicillins/therapeutic use , Uveitis/diagnosis , Uveitis/therapy , Syphilis/diagnosis , Epidemiology, Descriptive , Retrospective Studies , Fluorescent Treponemal Antibody-Absorption Test , Eye Diseases
18.
Braz. j. otorhinolaryngol. (Impr.) ; 86(3): 358-363, May-June 2020. tab, graf
Article in English | LILACS | ID: biblio-1132604

ABSTRACT

Abstract Introduction: A resurgence of syphilis in Brazil has been reported in recent years. Objective: With this in mind, the present study sought to investigate the frequency, demographics, and clinical characteristics of patients with acquired syphilis with oral involvement who received medical care at an Oral Medicine Reference Center in a Brazilian Public Hospital. Methods: A retrospective study, spanning a period of 12 years, was performed to identify changing trends in syphilis over time. Medical records from all patients diagnosed with acquired syphilis who received medical care at the Hospital's Oral Medicine Clinic from 2005 to 2016 were reviewed, and the demographic and clinical data were collected. Results: A total of 85 patients had been diagnosed with acquired syphilis, with a significant increase in the number of cases over the past 5 years. Patients ranged from 16 to 76 years of age, with a peak in the third and fourth decades. Forty-eight cases affected males (56.5%), while 37 cases affected females (43.5%). Most of the oral lesions appeared as unique ulcers or plaques, with the lips and tongue representing the most affected sites. All cases were positive for Venereal Disease Research Laboratory or Fluorescent Treponemal Antibody Absorption, and treatment was performed with Penicillin G benzathine in most cases (84.7%). Conclusion: The frequency of oral syphilis has been rising over time and oral lesions may well represent a diagnostic clue; therefore, oral health professionals must be made aware and properly trained in an attempt to develop a high degree of clinical suspicion in the diagnosis of syphilis.


Resumo Introdução: Um ressurgimento da sífilis no Brasil tem sido relatado nos últimos anos. Objetivo: Investigar a frequência, as características demográficas e clínicas dos pacientes com sífilis adquirida com envolvimento oral que receberam atendimento médico em um centro de referência em medicina oral em um hospital público brasileiro. Método: Estudo retrospectivo, abrangeu 12 anos, feito para identificar tendências de mudança na sífilis. Registros médicos de todos os pacientes diagnosticados com sífilis adquirida que receberam atendimento médico na clínica de medicina oral do hospital de 2005 a 2016 foram revisados e os dados demográficos e clínicos foram coletados. Resultados: Foram diagnosticas 85 pacientes com sífilis adquirida, com um aumento significativo no número de casos nos últimos 5 anos. A idade dos pacientes variou de 16 a 76 anos, com pico na terceira e quarta décadas; 48 casos eram do sexo masculino (56,5%) e 37 do sexo feminino (43,5%). A maioria das lesões orais apareceu como úlceras ou placas únicas, os lábios e a língua representaram os locais mais afetados. Todos os casos foram positivos para Venereal Disease Research Laboratory e Fluorescent Treponemal Antibody Absorption Test e o tratamento foi feito com penicilina G benzatina na maioria dos casos (84,7%). Conclusão: A frequência da sífilis oral tem aumentado com o tempo e as lesões orais podem representar uma pista diagnóstica; portanto, os profissionais de saúde bucal devem ser conscientizados e devidamente treinados na tentativa de desenvolver um alto grau de suspeição clínica no diagnóstico da sífilis.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Syphilis/diagnosis , Mouth Diseases/diagnosis , Penicillin G Benzathine/therapeutic use , Syphilis/drug therapy , Retrospective Studies , Mouth Diseases/drug therapy
20.
Rev. cuba. estomatol ; 57(1): e2171, ene.-mar. 2020. graf
Article in English | LILACS, CUMED | ID: biblio-1126493

ABSTRACT

ABSTRACT Introduction: Syphilis is classified as a sexually transmitted infectious-contagious disease with the causative agent Treponema pallidum (Tp). It presents distinct stages of evolution: The primary phase is characterized by the appearance of the hard chancre, the secondary phase by the spread of Tp through the bloodstream and systemic involvement, and the tertiary phase by organ infection and nervous system impairment. In congenital syphilis, the Tp is transmitted vertically from mother to child. Objective: Report a case in which the dental team participated in the diagnosis of syphilis. Case presentation: A male 26-year-old patient with leukoderma, HIV-positive and under regular antiretroviral treatment, with no other chronic systemic changes and no previous history of Tp infection, was referred for evaluation by the oral health team. The patient reported having had bisexual relations in recent months with a condom and orogenital contact without a condom. He had not noticed any type of "wound" on the body. Intraoral examination found multiple reddish macules scattered on the lingual dorsum, with a slight detachment and little pain. The quick test was a reagent for syphilis. The patient was referred for evaluation at the medical clinic. Treatment started by two applications of benzyl penicillin with a 7 days' separation between them. Complementary blood tests were also indicated, with special attention to VDRL, which eventually confirmed the Tp infection. Conclusions: Participation of the oral health team in the diagnosis of syphilis constitutes a complementary force for the improvement of health care processes(AU)


RESUMEN Introducción: La sífilis se clasifica como una enfermedad contagiosa infecciosa de transmisión sexual, con el agente causal Treponema pallidum (Tp). Presenta distintos estadios de evolución: la fase primaria caracterizada por la aparición del chancre duro; la fase secundaria, la diseminación de la Tp a través del torrente sanguíneo y la afectación sistémica; y la fase terciaria, en que hay infección de órganos y deterioro del sistema nervioso, además de sífilis congénita, forma esta en la que Tp es transmitida verticalmente por la mujer embarazada. Objetivo: Informar sobre un caso en el que la participación del equipo dental colaboró ​​en el proceso de diagnóstico de la sífilis. Presentación del caso: Paciente con 26 años de edad, leucodermia, VIH positivo y en tratamiento antirretroviral regular, sin otros cambios crónicos a nivel sistémico y sin antecedentes de infección por Tp. Se remitió para evaluación con el equipo de salud oral. Informó haber tenido relaciones bisexuales en los últimos meses con un condón y contacto orogenital sin condón. No notó ningún tipo de "herida" en el cuerpo. En el examen intrabucal, se encontraron múltiples máculas rojizas dispersas en el dorso lingual, con un ligero desprendimiento y con poco dolor. La prueba rápida fue un reactivo para sífilis. El paciente fue remitido para su evaluación a clínica médica. Comenzó el tratamiento con dos aplicaciones de penicilina bencilo, con un intervalo de 7 días y se solicitó análisis de sangre complementarios, con especial atención al VDRL, que posteriormente confirmó la infección por Tp. Conclusiones: La participación del equipo de salud bucal frente al diagnóstico de la sífilis, se constituye como una fuerza complementaria para la mejora de los procesos en salud(AU)


Subject(s)
Humans , Male , Adult , Penicillins/therapeutic use , Syphilis/diagnosis , Oral Health , Disease Transmission, Infectious/prevention & control
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