{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:12:08Z","timestamp":1792735928870,"version":"4.5.0"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>There has been a 291% relative increase in congenital syphilis (CS) cases in the United States from 2015 to 2019. Although the majority of affected fetuses\/infants are stillborn or are asymptomatic, a subset is born with severe clinical illness. We describe a series of severe CS cases in the neonatal intensive care unit.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Retrospective review of infants with CS, admitted to the Duke Intensive Care Nursery from June 2016 to February 2020. We recorded birthweight, gestational age, medications, procedures, diagnoses, laboratory data and outcomes. Severe symptoms included: birth depression, hypoxic ischemic encephalopathy (HIE), disseminated intravascular coagulopathy and\/or persistent pulmonary hypertension (PPHN).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Seven infants with CS were identified and 5 with severe presentations were included. Median gestational age was 35.1 weeks (range: 29\u201337 weeks, median: 35 weeks). All infants required intubation at birth, 2 required chest compressions and epinephrine in the delivery room. One had hydrops fetalis and died in the delivery room. All 4 surviving infants had HIE, severe PPHN, hepatitis and seizures. All infants had a positive rapid plasma reagin, and were treated with penicillin G. Maternal rapid plasma reagin was pending for 3 of 5 infants at delivery, and later returned positive; 2 were positive during pregnancy but not treated. Other infectious work-up was negative. Three infants survived to discharge.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>CS can be associated with HIE, PPHN and disseminated intravascular coagulopathy in affected infants. Clinicians should have a high index of suspicion and include CS in their differential diagnoses. This study also highlights the importance of adequate treatment of identified cases and screening during the third trimester and at delivery.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/inf.0000000000003370","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T12:08:22Z","timestamp":1633694902000},"page":"335-339","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Severe Congenital Syphilis in the Neonatal Intensive Care Unit: A Retrospective Case Series"],"prefix":"10.1097","volume":"41","author":[{"given":"Samia","family":"Aleem","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LaShawndra S.","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi D.","family":"Hornik","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke University"},{"name":"Duke Clinical Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad A.","family":"Grotegut","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Duke University, Durham"},{"name":"Department of Obstetrics and Gynecology, Wake Forest Baptist Health, Winston-Salem, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin E. D.","family":"Weimer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,10,6]]},"reference":[{"key":"R2-20250615","doi-asserted-by":"crossref","first-page":"661","DOI":"10.15585\/mmwr.mm6922a1","article-title":"missed opportunities for prevention of congenital syphilis - United States, 2018.","volume":"69","author":"Kimball","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"R3-20250615","doi-asserted-by":"crossref","first-page":"217","DOI":"10.2471\/BLT.12.107623","article-title":"Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis.","volume":"91","author":"Gomez","year":"2013","journal-title":"Bull World Health Organ"},{"issue":"Suppl 11","key":"R5-20250615","first-page":"1232","article-title":"Congenital syphilis associated with persistent pulmonary hypertension of the neonate\u2013a clinico-pathological case study.","volume":"85","author":"Smith","year":"1995","journal-title":"S Afr Med J"},{"key":"R6-20250615","first-page":"223","article-title":"Case report: congenital syphilis associated with persistent pulmonary hypertension of the newborn.","volume":"63","author":"Spear","year":"1991","journal-title":"Del Med J"},{"key":"R7-20250615","doi-asserted-by":"crossref","first-page":"508","DOI":"10.3389\/fped.2019.00508","article-title":"Non-immune hydrops fetalis and hepatic dysfunction in a preterm infant with congenital syphilis.","volume":"7","author":"Duby","year":"2019","journal-title":"Front Pediatr"},{"key":"R8-20250615","doi-asserted-by":"crossref","first-page":"e0211720","DOI":"10.1371\/journal.pone.0211720","article-title":"Global burden of maternal and congenital syphilis and associated adverse birth outcomes-estimates for 2016 and progress since 2012.","volume":"14","author":"Korenromp","year":"2019","journal-title":"PLoS One"},{"key":"R11-20250615","doi-asserted-by":"crossref","first-page":"2328","DOI":"10.1001\/jama.2016.4114","article-title":"Screening for syphilis: updated evidence report and systematic review for the US preventive services task force.","volume":"315","author":"Cantor","year":"2016","journal-title":"JAMA"},{"key":"R13-20250615","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1001\/jama.2018.11785","article-title":"Screening for syphilis infection in pregnant women: US preventive services task force reaffirmation recommendation statement.","volume":"320","author":"Curry","year":"2018","journal-title":"JAMA"},{"key":"R15-20250615","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1007\/s10995-018-2592-0","article-title":"State requirements for prenatal syphilis screening in the United States, 2016.","volume":"22","author":"Warren","year":"2018","journal-title":"Matern Child Health J"}],"container-title":["Pediatric Infectious Disease Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/INF.0000000000003370","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T16:03:59Z","timestamp":1750003439000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/INF.0000000000003370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,6]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/inf.0000000000003370","relation":{},"ISSN":["0891-3668"],"issn-type":[{"value":"0891-3668","type":"print"}],"subject":[],"published":{"date-parts":[[2021,10,6]]}}}