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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2018; 76(09): 640
DOI: 10.1590/0004-282X20180086
Letter

Late-onset congenital syphilis: is it another disease?

Sífilis congênita tardia: trata-se de outra doença?
Won Sriwijitalai
1   RVT Medical Center, Bangkok, Thailand
,
Viroj Wiwanitkit
2   Hainan Medical University, China; honorary professor, dr DY Patil University, India
DY Patil University, India
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Dear Editor,

We read the publication on “Late-onset congenital syphilis with unusual brain abnormalities” with great interest[1]. The atypical neurological finding and interesting blood and cerebrospinal fluid (CSF) serological findings are reported and Silva et al.[1] concluded that this case was a late-onset congenital syphilis. This may or may not be a late-onset congenital syphilis. The main points that might not support the diagnosis of late-onset congenital syphilis are: a) the lack of additional clinical history of other clinical features of late syphilis, b) the negative CSF VDRL, c) no clinical data on the present syphilis status of the patient's mother and d) the uncommon neurological imaging finding. False positive and negative results may have occurred in the present case[2]. The clinical finding and laboratory result may be features of other diseases, especially autoimmune diseases[3]. The lack of a CSF PCR test for final confirmation of neurosyphilis infection results in an inconclusive diagnosis. Nevertheless, in case that it is a real late syphilis with an atypical neurological feature, the authors cannot make a diagnosis that this is a congenital case with confirmed vertical transmission since is not possible to rule out the possibility of a non-vertical transmission in this female adolescent.



Publikationsverlauf

Eingereicht: 07. Dezember 2017

Angenommen: 03. Juni 2018

Artikel online veröffentlicht:
22. August 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Silva RAE, Campelo C, Godeiro-Junior C. Late-onset congenital syphilis with unusual brain abnormalities. Arq Neuropsiquiatr. 2017 Sep;75(9):676. https://doi.org/10.1590/0004-282x20170118
  • 2 Nishii H, Matsumoto T. [Tests for syphilis]. Nihon Rinsho. 2005 Jul;63 Suppl 7:140-1. Japanese.
  • 3 Nandwani R, Evans DT. Are you sure it's syphilis? A review of false positive serology. Int J STD AIDS. 1995 Jul-Aug;6(4):241-8. https://doi.org/10.1177/095646249500600404