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In recent years, rates of syphilis in adults have been on the rise resulting in an increase in the number of neonates born with congenital syphilis. National organizations including the Centers for Disease Control and Prevention as well as The US Preventative Services Task Force recommend routine testing of pregnant persons to identify and provide maternal syphilis treatment prior to delivery. Significant variability exists between states for these screenings, resulting in some pregnant persons not being diagnosed prior to delivery. The Pediatric Pharmacy Association (PPA) believes that pharmacists, along with other health care providers can help by ensuring optimal syphilis testing and treatment pathways for pregnant individuals and newborns are included in their workplaces. PPA also supports pharmacists working to increase treatment compliance by providing medication education and counseling regarding optimal treatment of syphilis infections, as well as work with state and local governments to standardize treatment recommendations.

The global resurgence of syphilis has created a potent stimulus for vaccine development. To identify potentially protective antibodies (Abs) against Treponema pallidum (TPA), we used Pyrococcus furiosus thioredoxin (PfTrx) to display extracellular loops (ECLs) from three TPA outer membrane protein families (outer membrane factors for efflux pumps, eight-stranded β-barrels, and FadLs) to assess their reactivity with immune rabbit serum (IRS). Five ECLs from the FadL orthologs TP0856, TP0858 and TP0865 were immunodominant. Rabbits and mice immunized with these five PfTrx constructs produced ECL-specific Abs that promoted opsonophagocytosis of TPA by rabbit peritoneal and murine bone marrow-derived macrophages at levels comparable to IRS and mouse syphilitic serum. ECL-specific rabbit and mouse Abs also impaired viability, motility, and cellular attachment of spirochetes during in vitro cultivation. The results support the use of ECL-based vaccines and suggest that ECL-specific Abs promote spirochete clearance via Fc receptor-independent as well as Fc receptor-dependent mechanisms.

Primary rectal syphilis is a rare disease that can be misdiagnosed as lymphoma or other rectal cancers on sigmoidoscopy or CT. Here, we report a case of primary rectal syphilis mimicking rectal malignancy in a 23-year-old male who presented with a rectal mass and multiple lymphadenopathies. In this case report and literature review, we focused on the CT findings and endoscopic observations of primary rectal syphilis. Infectious diseases, such as rectal syphilis, should be considered in the differential diagnosis of young patients with unusual rectal lesions and disproportionately extensive lymphadenopathies.
원발성 직장 매독은 드문 질환으로 대장내시경이나 컴퓨터단층촬영에서 림프종이나 다른 직장암으로 오진될 수 있다. 이에 저자는 직장 병변과 다수의 림프절병증으로 발현하여 직장 종양으로 오인되었던 23세 남자 환자의 원발성 직장 매독 증례를 보고하고자 한다. 이 증례 보고는 원발성 직장 매독이라는 드문 질환의 컴퓨터단층촬영과 내시경 소견에 초점을 둔다. 이와 같이 비전형적인 직장 종괴와 이에 비해 광범위한 림프절병증을 가지고 있는 젊은 환자를 진료할 때 우리는 직장 매독과 같은 감염성 질병을 감별 질환으로 고려해 볼 수 있다.

BackgroundSyphilis in blood donors (BD) has increased in many countries.AimWe aimed to describe trends in syphilis seroposivity in BD in France, to identify risk factors and assess if a non-treponemic test (NTT) could define BD having recovered from syphilis for more than 1 year.MethodsThe analysis covered the period 2007 to 2022 and 45,875,939 donations. Of the 474 BD syphilis-positive in 2022, 429 underwent additional investigations with an NTT. History of syphilis was obtained at the post-donation interview or based on serology results for repeat donors.ResultsUntil 2021, positivity rates remained stable (mean: 1.18/10,000 donations, range: 1.01-1.38). An increased rate was observed in 2022 (1.74/10,000; p = 0.02). Over the whole study period, prevalence was 2.2 times higher in male than in female BD (4.1 times higher in 2022). The proportion of males with an identified risk factor who have sex with men increased from 16.7% in 2007 to 64.9% in 2022. Based on NTT, 79 (18%) of the donors who were seropositive in 2022 were classified as having been infected in the previous year. History of syphilis was available for 30 of them. All had an infection within the previous 3 years. Among seven donors with a syphilis < 12 months before testing, one had an NTT titre ≥ 8, three a titre between 1 and 4, three were negative.ConclusionSyphilis seropositivity increased considerably in BDs in 2022, mostly in males, notably MSM. Available data did not allow appropriate evaluation of the NTT to distinguish recent from past infection.

Syphilis-the \"great simulator\" for classical venereologists-is re-emerging in Western countries despite adequate treatment; several contributing factors have been identified, including changes in sexual behaviour, which won\'t be the topic of this article though.In 2021, a total of 6613 new cases of syphilis were reported in Spain, representing an incidence of 13.9 x 100 000 inhabitants (90.5%, men). Rates have increased progressively since 2000.The clinical presentation of syphilis is heterogeneous. Although chancroid, syphilitic roseola and syphilitic nails are typical lesions, other forms of the disease can be present such as non-ulcerative primary lesions like Follmann balanitis, chancres in the oral cavity, patchy secondary lingual lesions, or enanthema on the palate and uvula, among many others.Regarding diagnosis, molecular assays such as PCR have been replacing dark-field microscopy in ulcerative lesions while automated treponemal tests (EIA, CLIA) are being used in serological tests, along with classical tests (such as RPR and HAART) for confirmation and follow-up purposes. The interpretation of these tests should be assessed in the epidemiological and clinical context of the patient. HIV serology and STI screening should be requested for anyone with syphilis.Follow-up of patients under treatment is important to ensure healing and detect reinfection. Serological response to treatment should be assessed with the same non-treponemal test (RPR/VDRL); 3-, 6-, 12-, and 24-month follow-up is a common practice in people living with HIV (PLHIV).Sexual contacts should be assessed and treated as appropriate.Screening is advised for pregnant women within the first trimester of pregnancy. Pregnant women with an abortion after week 20 should all be tested for syphilis.The treatment of choice for all forms of syphilis, including pregnant women and PLHIV, is penicillin. Macrolides are ill-advised because of potential resistance.

Syphilis can affect multiple organs in the secondary or tertiary stages of the disease. Recent reports have suggested an increase in the incidence of the disease. Involvement of the lung has been rarely described in syphilis. In this report, we discuss the case of a 26-year-old female with past medical history significant for HIV who presented to the hospital with complaints of shortness of breath and underwent thoracentesis; she was found to have syphilis with pulmonary involvement.

Introduction Congenital Syphilis (CS) is considered the second leading cause of preventable death in developing countries. The last report of the incidence rate of CS was made in 2017. Objective The objective of the study was to estimate the incidence of CS between 2019-2023. Materials and methods This is a retrospective study for which data were obtained from the new cases of CS reported in the Epidemiological Bulletin for 2019-2023 and from the newborn population records reported in the National Institute of Statistics and Geography and the National Population Council. Results In Mexico, the incidence rate of CS is 3.20 per 10,000 births. An increment of CS cases was observed between 2019-2023, with a higher number of cases in 2022. Conclusion A democratization of detection and prompt management is needed to reduce transmission, particularly among the most vulnerable population.

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