Diagnosis of congenital syphilis and toxoplasmosis
C. R. Robert George
+ Author Affiliations
- Author Affiliations
Department of Microbiology
SEALS, NSW Health Pathology
The Prince of Wales Hospital
Randwick, NSW 2031, Australia
Tel: +61 2 9382 9054
Fax: +61 2 9382 9098
Email: Robert.George@sesiahs.health.nsw.gov.au
Microbiology Australia 36(4) 184-189 https://doi.org/10.1071/MA15065
Published: 28 October 2015
Abstract
Syphilis, toxoplasmosis, and cytomegalovirus represent disparate entities. The bacterial spirochaete Treponema pallidum ssp. pallidum causes syphilis, the ‘The Great Imitator'; the organism's sole natural host is humans and it remains exquisitely sensitive to penicillin. By contrast, the zoonotic parasite Toxoplasma gondii causes toxoplasmosis. Infection is usually self-limited, although serious disease can occur in the immunocompromised. Meanwhile, the human cytomegalovirus (CMV; human herpesvirus 5) is a relatively prevalent enveloped DNA betaherpesvirus with infection specific to humans. Despite nomenclatural, ecological and therapeutic disparities, however, these agents exhibit several concordances, including various, and at times, cryptic syndromes in child and often mother; congenital infections with potentially devastating outcomes; diagnostic dilemmas. This article primarily discusses the latter of these issues in relationship to congenital syphilis and toxoplasmosis in the Australian context.
References
[1] Australian Government Department of Health (2015) National Notifiable Diseases Surveillance System 2015, 10 August 2015. http://www9.health.gov.au/cda/source/rpt_2_sel_a.cfm[2] Read, P. et al. (2015) Increasing trends of syphilis among men who have sex with men in high income countries. Sex. Health 12, 155–163.
| Increasing trends of syphilis among men who have sex with men in high income countries.Crossref | GoogleScholarGoogle Scholar |
[3] Kwan, K.S. et al. (2012) Syphilis epidemiology and public health interventions in Western Australia from 1991 to 2009. Sex. Health 9, 272–279.
| Syphilis epidemiology and public health interventions in Western Australia from 1991 to 2009.Crossref | GoogleScholarGoogle Scholar | 22697145PubMed |
[4] Chakraborty, R. and Luck, S. (2007) Managing congenital syphilis again? The more things change. Curr. Opin. Infect. Dis. 20, 247–252.
| Managing congenital syphilis again? The more things change.Crossref | GoogleScholarGoogle Scholar | 17471033PubMed |
[5] Simms, I. and Ward, H. (2006) Congenital syphilis in the United Kingdom. Sex. Transm. Infect. 82, 1.
| Congenital syphilis in the United Kingdom.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28%2Fnslaksw%3D%3D&md5=1859080ea48bd55d3ce0afcaff16a4daCAS | 16461590PubMed |
[6] Centers for Disease Control and Prevention (2014) 2013 Sexually Transmitted Diseases Surveillance. Atlanta: US Department of Health and Human Services.
[7] Wicher, V. and Wicher, K. (2001) Pathogenesis of maternal-fetal syphilis revisited. Clin. Infect. Dis. 33, 354–363.
| Pathogenesis of maternal-fetal syphilis revisited.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MzosVCktQ%3D%3D&md5=0e1d6ae22294be14914efaac56476621CAS | 11438902PubMed |
[8] World Health Organization (2007) The Global elimination of congenital syphilis: rationale and strategy for action. World Health Organization.
[9] De Santis, M. et al. (2012) Syphilis infection during pregnancy: fetal risks and clinical management. Infect. Dis. Obstet. Gynecol. 2012, 430585.
| Syphilis infection during pregnancy: fetal risks and clinical management.Crossref | GoogleScholarGoogle Scholar | 22829747PubMed |
[10] The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (2015) College Statement C-Obs 3 (b): Routine Antenatal Assessment in the Absence of Pregnancy Complications.
[11] Australian Health Ministers’ Advisory Council (2012) Clinical Practice Guidelines: Antenatal Care – Module 1. Canberra. http://www.health.gov.au/antenatal
[12] Public Health Laboratory Network (2012) Syphilis Laboratory Case Definition (LCD). (Australian Government Department of Health, ed.) Australian Government Department of Health.
[13] Communicable Diseases Network Australia (2015) Syphilis (congenital) case definition. (Australian Government Department of Health, ed.) Australian Government Department of Health.
[14] Palasanthiran, P. et al. eds (2014) Management of Perinatal Infections. Australasian Society for Infectious Diseases, Sydney.
[15] Liu, L.L. et al. (2014) Incidence and risk factors for the prozone phenomenon in serologic testing for syphilis in a large cohort. Clin. Infect. Dis. 59, 384–389.
| Incidence and risk factors for the prozone phenomenon in serologic testing for syphilis in a large cohort.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2cXhtlSrurnP&md5=81848cc10bbd0b8882210511acb8da4fCAS | 24803377PubMed |
[16] Centers for Disease Control (1988) Guidelines for the prevention and control of congenital syphilis. MMWR Morb. Mortal. Wkly. Rep. 37, 1–13.
| 2842647PubMed |
[17] van Dyck, E. et al. (2001) Effect of adverse storage conditions of antigen reagent on performance of the rapid plasma reagin test. Int. J. STD AIDS 12, 299–301.
| Effect of adverse storage conditions of antigen reagent on performance of the rapid plasma reagin test.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M3nslSmtQ%3D%3D&md5=b823581cf1f811e015e0f975dfd275c8CAS | 11368802PubMed |
[18] Arnold, S.R. and Ford-Jones, E.L. (2000) Congenital syphilis: a guide to diagnosis and management. Paediatr. Child Health 5, 463–469.
| 1:STN:280:DC%2BC3c7ivFSquw%3D%3D&md5=3ab19f33e10f0f39ac4cd373ecf03ea9CAS | 20177559PubMed |
[19] Jayamaha, J.C. et al. (2012) Congenital toxoplasmosis over 10 years in a low-incidence population. Med. J. Aust. 196, 443–444.
| Congenital toxoplasmosis over 10 years in a low-incidence population.Crossref | GoogleScholarGoogle Scholar | 22509871PubMed |
[20] FSANZ (2013) Toxoplasma gondii. In Agents of Foodborne Illness, 2nd edn (Food Standards Australia New Zealand, ed.) pp. 103–114. Canberra.
[21] Hill, D. and Dubey, J.P. (2002) Toxoplasma gondii: transmission, diagnosis and prevention. Clin. Microbiol. Infect. 8, 634–640.
| Toxoplasma gondii: transmission, diagnosis and prevention.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38njt1emtA%3D%3D&md5=5b2f80e719080ad414bd176c2158cd7cCAS | 12390281PubMed |
[22] Gilbert, G.L. (2002) 1: Infections in pregnant women. Med. J. Aust. 176, 229–236.
| 11999241PubMed |
[23] McAuley, J.B. (2014) Congenital Toxoplasmosis. J. Pediatric Infect. Dis. Soc. 3, S30–S35.
| Congenital Toxoplasmosis.Crossref | GoogleScholarGoogle Scholar | 25232475PubMed |
[24] McAuley, J. et al. (1994) Early and longitudinal evaluations of treated infants and children and untreated historical patients with congenital toxoplasmosis: the Chicago Collaborative Treatment Trial. Clin. Infect. Dis. 18, 38–72.
| Early and longitudinal evaluations of treated infants and children and untreated historical patients with congenital toxoplasmosis: the Chicago Collaborative Treatment Trial.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2czjtFGjtQ%3D%3D&md5=1030a4233757c50f2b64a491e0832c27CAS | 8054436PubMed |
[25] Foulon, W. (1992) Congenital toxoplasmosis: is screening desirable? Scand. J. Infect. Dis. Suppl. 84, 11–17.
| 1:STN:280:DyaK3s7nsVajuw%3D%3D&md5=01a0a1440a317f9ba38f127a9845ec58CAS | 1290068PubMed |
[26] Di Mario, S. et al. (2013) Prenatal education for congenital toxoplasmosis. Cochrane Database Syst. Rev. , CD006171.
| 23450566PubMed |
[27] Paquet, C. and Yudin, M.H. (2013) Toxoplasmosis in pregnancy: prevention, screening, and treatment. J. Obstet. Gynaecol. Can. 35, 78–81.
| 23343802PubMed |
[28] Bénard, A. et al. (2008) Survey of European programmes for the epidemiological surveillance of congenital toxoplasmosis. Euro Surveill. 13, 18834.
| 18445459PubMed |
[29] Montoya, J.G. and Remington, J.S. (2008) Management of Toxoplasma gondii infection during pregnancy. Clin. Infect. Dis. 47, 554–566.
| Management of Toxoplasma gondii infection during pregnancy.Crossref | GoogleScholarGoogle Scholar | 18624630PubMed |
[30] Montoya, J.G. (2002) Laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis. J. Infect. Dis. 185, S73–S82.
| Laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis.Crossref | GoogleScholarGoogle Scholar | 11865443PubMed |
[31] Sensini, A. (2006) Toxoplasma gondii infection in pregnancy: opportunities and pitfalls of serological diagnosis. Clin. Microbiol. Infect. 12, 504–512.
| Toxoplasma gondii infection in pregnancy: opportunities and pitfalls of serological diagnosis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD283nt1Srtw%3D%3D&md5=a53d41f36aad95a262923ecfc1a9e503CAS | 16700697PubMed |
[32] Lebech, M. et al. (1996) Classification system and case definitions of Toxoplasma gondii infection in immunocompetent pregnant women and their congenitally infected offspring. European Research Network on Congenital Toxoplasmosis. Eur. J. Clin. Microbiol. Infect. Dis. 15, 799–805.
| Classification system and case definitions of Toxoplasma gondii infection in immunocompetent pregnant women and their congenitally infected offspring. European Research Network on Congenital Toxoplasmosis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s7gslygsA%3D%3D&md5=1e3917f0bb10648cf69d42d5bdaeef0fCAS | 8950557PubMed |
[33] Stronati, M. et al. (1998) Application and evaluation of a classification system and case definitions of Toxoplasma gondii infection. Eur. J. Clin. Microbiol. Infect. Dis. 17, 67–68.
| Application and evaluation of a classification system and case definitions of Toxoplasma gondii infection.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c7ntFWntg%3D%3D&md5=2ad5f7c65cb70dcaffa400c0629d4de9CAS | 9512192PubMed |
[34] Liesenfeld, O. et al. (2001) Effect of testing for IgG avidity in the diagnosis of Toxoplasma gondii infection in pregnant women: experience in a US reference laboratory. J. Infect. Dis. 183, 1248–1253.
| Effect of testing for IgG avidity in the diagnosis of Toxoplasma gondii infection in pregnant women: experience in a US reference laboratory.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M3mtVaktw%3D%3D&md5=1e2972c532aab8a0bbed59137876eb94CAS | 11262207PubMed |
[35] Akolekar, R. et al. (2015) Procedure-related risk of miscarriage following amniocentesis and chorionic villus sampling: a systematic review and meta-analysis. Ultrasound Obstet. Gynecol. 45, 16–26.
| Procedure-related risk of miscarriage following amniocentesis and chorionic villus sampling: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC2cbktVKgsQ%3D%3D&md5=97ec4dd0e61a6b7b9fe5348c6da65b71CAS | 25042845PubMed |
[36] Antsaklis, A. et al. (2002) Prenatal diagnosis of congenital toxoplasmosis. Prenat. Diagn. 22, 1107–1111.
| Prenatal diagnosis of congenital toxoplasmosis.Crossref | GoogleScholarGoogle Scholar | 12454967PubMed |
[37] Moncada, P.A. and Montoya, J.G. (2012) Toxoplasmosis in the fetus and newborn: an update on prevalence, diagnosis and treatment. Expert Rev. Anti Infect. Ther. 10, 815–828.
| Toxoplasmosis in the fetus and newborn: an update on prevalence, diagnosis and treatment.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38Xht1yqtbfP&md5=d065153129c8f3d256f11b4217c7d7fbCAS | 22943404PubMed |
[38] Fuentes, I. et al. (1996) Urine sample used for congenital toxoplasmosis diagnosis by PCR. J. Clin. Microbiol. 34, 2368–2371.
| 1:STN:280:DyaK2s%2FjsVyhtw%3D%3D&md5=c68289a71083d46e6c1aed9cdb03beb6CAS | 8880481PubMed |
[39] Holliman, R.E. et al. (1994) The diagnosis of toxoplasmosis using IgG avidity. Epidemiol. Infect. 112, 399–408.
| The diagnosis of toxoplasmosis using IgG avidity.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2c3gtVejtg%3D%3D&md5=c0b69831fe55cea5946b832ff67bcb02CAS | 8150014PubMed |
