{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T23:13:51Z","timestamp":1778109231964,"version":"3.51.4"},"reference-count":48,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T00:00:00Z","timestamp":1658707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>A case of vertical transmission in a 35-year-old pregnant woman, gravida 4, para 2 with an unknown medical history of carrying primary syphilis is described. A routine 3rd trimester scan was performed at 30 + 5 weeks of pregnancy, which revealed fetal growth restriction (FGR) associated with absent fetal movement, a pathologic neuroscan characterized by cortical calcifications and ominous Doppler waveform analysis of the umbilical artery and ductus venosus. Computerized electronic fetal monitoring (EFM) showed a Class III tracing, according to the American College of Obstetricians and Gynecologists (ACOG) guidelines. An emergency C-section was performed and a female newborn weighing 1470 g was delivered. The Apgar scores were 5 and 8 at the first and fifth min, respectively. Besides the prompted obstetrical and neonatal interventions, the neonate died after 7 days. A histologic examination of the placenta revealed a chorioamnionitis at stage 1\/2 and grade 2\/3. The parenchyma showed diffuse delayed villous maturation, focal infarcts, and intraparenchymal hemorrhages. The decidua presented with chronic deciduitis with plasma cells. The parents declined the autopsy. Congenital syphilis is an emerging worldwide phenomenon and the multidisciplinary management of the mother and the fetus should be mandatory.<\/jats:p>","DOI":"10.3390\/microorganisms10081497","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T21:20:59Z","timestamp":1658784059000},"page":"1497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Congenital Syphilis Presenting with Brain Abnormalities at Neuroscan: A Case Report and a Brief Literature Review"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2620-7486","authenticated-orcid":false,"given":"Gabriele","family":"Tonni","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Neonatology and Researcher, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), AUSL Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianpaolo","family":"Grisolia","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Carlo Poma Hospital, ASST Mantova, 46100 Mantova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlene","family":"Pisello","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Carlo Poma Hospital, ASST Mantova, 46100 Mantova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Zampriolo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Carlo Poma Hospital, ASST Mantova, 46100 Mantova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria","family":"Fasolato","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit (NICU), Carlo Poma Hospital, ASST Mantova, 46100 Mantova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1332-0989","authenticated-orcid":false,"given":"Paola","family":"Sindico","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit (NICU), Carlo Poma Hospital, ASST Mantova, 46100 Mantova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-2532","authenticated-orcid":false,"given":"Edward","family":"Ara\u00fajo Junior","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Universitade Federal de Sao Paulo, Sao Paulo 04021-001, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4889-1944","authenticated-orcid":false,"given":"Maria Paola","family":"Bonasoni","sequence":"additional","affiliation":[{"name":"Pathology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), AUSL Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17073","DOI":"10.1038\/nrdp.2017.73","article-title":"Syphilis","volume":"3","author":"Peeling","year":"2017","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1016\/S0140-6736(16)32411-4","article-title":"Syphilis","volume":"389","author":"Hook","year":"2017","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s40471-018-0138-z","article-title":"An Update on the Global Epidemiology of Syphilis","volume":"1","author":"Kojima","year":"2018","journal-title":"Curr. Epidemiol. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e1110","DOI":"10.1016\/S2214-109X(21)00221-7","article-title":"Prevalence of syphilis among men who have sex with men: A global systematic review and meta-analysis from 2000\u20132020","volume":"8","author":"Tsuboi","year":"2021","journal-title":"Lancet Glob. Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.clp.2021.03.005","article-title":"Syphilis in Neonates and Infants","volume":"2","author":"Medoro","year":"2021","journal-title":"Clin. Perinatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1097\/OLQ.0000000000001364","article-title":"Estimates of the Prevalence and Incidence of Syphilis in the United States, 2018","volume":"48","author":"Spicknall","year":"2021","journal-title":"Sex Transm. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"adv00114","DOI":"10.2340\/00015555-3470","article-title":"The Changing Spectrum of Sexually Transmitted Infections in Europe","volume":"100","author":"Stary","year":"2020","journal-title":"Acta Derm. Venereol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Korenromp, E.L., Rowley, J., Alonso, M., Mello, M.B., Wijesooriya, N.S., Mahian\u00e9, S.G., Ishikawa, N., Le, L.V., Newman-Owiredu, M., and Nagelkerke, N. (2019). Global burden of maternal and congenital syphilis and associated adverse birth outcomes-Estimates for 2016 and progress since 2012. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0219613"},{"key":"ref_9","unstructured":"European Centre for Disease Prevention and Control (2018). Congenital Syphilis, ECDC Annual Epidemiological Report for 2016."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3608","DOI":"10.1073\/pnas.85.10.3608","article-title":"Treponema pallidum invades intercellular junction of endothelial cell monolayers","volume":"85","author":"Thomas","year":"1988","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_11","unstructured":"Organiza\u00e7\u00e3o Mundial de Sa\u00fade (2008). Elimina\u00e7\u00e3o Mundial da S\u00edfilis Cong\u00e9nita: Fundamento L\u00f3gico e Estrat\u00e9gia para Ac\u00e7\u00e3o."},{"key":"ref_12","unstructured":"Lukehart, S.A. (2012). Syphilis. Harrison\u2019s Principles of Internal Medicine, McGraw-Hill."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/S0146-0005(98)80021-9","article-title":"Syphilis","volume":"22","author":"Hollier","year":"1998","journal-title":"Semin. Perinatol."},{"key":"ref_14","first-page":"424","article-title":"The prevention and management of congenital syphilis: An overview and recommendations","volume":"82","author":"Salooje","year":"2004","journal-title":"Bull. World Health Organ."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1258\/09564620260079653","article-title":"WHO Antenatal Care Trial Research Group. The epidemiology of syphilis in pregnancy","volume":"13","author":"Lubiganon","year":"2001","journal-title":"Int. J. STD AIDS"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Qin, J., Yang, T., Xiao, S., Tan, H., Feng, T., and Fu, H. (2014). Reported estimates of adverse pregnancy outcomes among women with and without syphilis: A systematic review and meta-analysis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0102203"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"158","DOI":"10.2471\/BLT.13.118604","article-title":"The sound of silence: Missing the opportunity to save lives at birth","volume":"91","author":"Klausner","year":"2013","journal-title":"Bull. World Health Organ."},{"key":"ref_18","unstructured":"World Health Organization (2012). Department of Reproductive Health and Research. Investment Case for Eliminating Mother-to-Child Transmission of Syphilis: Promoting Better Maternal and Child Health and Stronger Health Systems."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Newman, L., Kamb, M., Hawkes, S., Gomez, G., Say, L., Seuc, A., and Broutet, N. (2013). Global estimates of syphilis in pregnancy and associated adverse outcomes: Analysis of multinational antenatal surveillance data. PLoS Med., 10.","DOI":"10.1371\/journal.pmed.1001396"},{"key":"ref_20","unstructured":"World Health Organization, Department of Reproductive Health and Research (2016, August 20). The Global Elimination of Congenital Syphilis: Rationale and Strategy for Action. Available online: http:\/\/apps.who.int\/iris\/bitstream\/10665\/43782\/1\/9789241595858_eng.pdf."},{"key":"ref_21","unstructured":"(2022, July 19). I Nuovi Livelli Essenziali di Assistenza (LEA). Available online: https:\/\/temi.camera.it."},{"key":"ref_22","unstructured":"SIEOG (1996). Linee Guida per Gli Screening Ecografici in Ostetricia e Ginecologia, CIC Edizioni Internazionali."},{"key":"ref_23","unstructured":"(2022, July 19). Fetal Heart Rate Monitoring During Labor|ACOG. Available online: https:\/\/www.acog.org."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/S0022-3476(78)80282-0","article-title":"Incidence and evolution of subependymal and intraventricular henmorrhage: A study of infants with birth weights less than 1500 gm","volume":"92","author":"Papile","year":"1978","journal-title":"J. Pediatr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1111\/j.1471-0528.2007.01327.x","article-title":"Placenta weight percentile curves for singleton deliveries","volume":"114","author":"Thompson","year":"2007","journal-title":"BJOG"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Kraus, F.T., Redline, R.W., Gersell, D.J., Nelson, D.M., and Dicke, J.M. (2004). Chapter 5 Inflammation and Infection. Placental Pathology, Armed Forces Institute of Pathology (AFIP).","DOI":"10.55418\/1881041891"},{"key":"ref_27","first-page":"947","article-title":"Fetal Syphilis: Clinical and Laboratory Characteristics","volume":"97","author":"Hollier","year":"2001","journal-title":"Obstet. Gynecol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"426.e1","DOI":"10.1016\/j.ajog.2014.05.049","article-title":"Progression of ultrasound findings of fetal syphilis after maternal treatment","volume":"211","author":"Rac","year":"2014","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_29","first-page":"97","article-title":"Fetal Syphilis: Correlation of Sonographic Findings and Rabbit Infectivity Testing of Amniotic Fluid","volume":"2","author":"Lawrence","year":"1993","journal-title":"J. Ultrasound Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1093\/cid\/ciaa349","article-title":"Sensitivity and Specificity of Treponemal-specific Tests for the Diagnosis of Syphilis","volume":"71","author":"Park","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_31","unstructured":"Centers for Disease Control and Prevention (2022, July 10). Sexually Transmitted Infections Treatment Guidelines, Available online: https:\/\/www.cdc.gov\/std\/treatment-guidelines\/toc.htm."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1002\/(SICI)1097-0223(199702)17:2<119::AID-PD39>3.0.CO;2-T","article-title":"In Utero Infection with Treponema Pallidium in Early Pregnancy","volume":"17","author":"Lawrence","year":"1997","journal-title":"Prenat. Diagn."},{"key":"ref_33","first-page":"890","article-title":"Identification of Treponema Pallidum in Amniotic Fluid and Fetal Blood from Pregnancies Complicated by Congenital Syphilis","volume":"78","author":"Wendel","year":"1991","journal-title":"Obstet. Gynecol."},{"key":"ref_34","first-page":"967","article-title":"Examination of amniotic fluid in diagnosis congenital syphilis with fetal death","volume":"60","author":"Wendel","year":"1989","journal-title":"Obstet. Gynecol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"S200","DOI":"10.1086\/342108","article-title":"Treatment of syphilis in pregnancy and prevention of congenital syphilis","volume":"35","author":"Wendel","year":"2002","journal-title":"Clin. Infect. Dis."},{"key":"ref_36","first-page":"478436","article-title":"Prenatal diagnosis of congenital syphilis using two- and three-dimensional ultrasonography: Case report","volume":"2012","author":"Santana","year":"2012","journal-title":"Case. Rep. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1002\/pd.6135","article-title":"Fetal and neonatal abnormalities due to congenital syphilis: A literature review","volume":"42","author":"David","year":"2022","journal-title":"Prenat. Diagn."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1097\/00007435-198510000-00002","article-title":"Early Congenital Syphilis: Clinico-Radiologic Features in 202 Patients","volume":"12","author":"Hira","year":"1985","journal-title":"Sex. Trans. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1002\/j.1536-4801.1984.tb08720.x","article-title":"Clinical Manifestations of Congenital Syphilitic Hepatitis: Implications for Pathogenesis","volume":"3","author":"Long","year":"1984","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_40","first-page":"157","article-title":"Congenital Syphilitic Hepatitis","volume":"28","author":"Anand","year":"1991","journal-title":"Indian Pediatrics"},{"key":"ref_41","first-page":"126","article-title":"Placental histopathology of congenital syphilis","volume":"100","author":"Sheffield","year":"2002","journal-title":"Obstet. Gynecol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/0046-8177(93)90016-A","article-title":"Placental histopathology in syphilis","volume":"24","author":"Qureshi","year":"1993","journal-title":"Hum. Pathol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/S0046-8177(96)90110-0","article-title":"Diagnosis of congenital syphilis from placental examination: Comparison of histopathology, Steiner stain, and polymerase chain reaction for Treponema pallidum DNA","volume":"27","author":"Genest","year":"1996","journal-title":"Hum. Pathol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/00006250-199102000-00011","article-title":"Doppler systolic-diastolic ratios in pregnancies complicated by syphilis","volume":"77","author":"Lucas","year":"1991","journal-title":"Obstet. Gynecol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1080\/15513815.2018.1485798","article-title":"Fetal and Placental Pathology in Congenital Syphilis: A Comprehensive Study in Perinatal Autopsy","volume":"37","author":"Kittipornpechdee","year":"2018","journal-title":"Fetal Pediatr. Pathol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1093\/clinids\/24.1.24","article-title":"Congenital syphilis: Detection of Treponema pallidum in stillborns","volume":"24","author":"Rawstron","year":"1997","journal-title":"Clin. Infect. Dis."},{"key":"ref_47","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."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.jgyn.2007.08.006","article-title":"Syphilis et grossesse. Etude de 85 cas en Guyane fran\u00e7aise [Syphilis and pregnancy]","volume":"37","author":"Carles","year":"2008","journal-title":"J. Gynecol. Obstet. Biol. Reprod."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/10\/8\/1497\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:56:04Z","timestamp":1760140564000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/10\/8\/1497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,25]]},"references-count":48,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["microorganisms10081497"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms10081497","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,25]]}}}