Congenital syphilis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
Pathophysiology of congenital syphilis is still unclear. Several theories have been postulated in regards to duration of infection in mother and stage of pregnancy.
Pathophysiology
Transmission
Congenital syphilis occurs by the transmission of T. pallidum from mother to fetus through placenta during pregnancy. Transmission of the infection to the fetus depends on the duration of the disease in the mother. The longer the mother has had the disease at the time of pregnancy, the chance of fetal infection decreases (40% in early latency and 10% in late latency).[1]
In utero transmission may occur at any stage of disease, but higher rates are seen with untreated infections of first and second trimester. It was postulated by Kassowitz that reduction in transplacental infection with progression of maternal syphilis is related to evolution of maternal immunity.[2] Recent theories suggest that the possibility of transmission is never eliminated. Fiumara gave an example of a untreated syphilitic mother transmitting disease to her children with decreasing frequency of severity. Interesting observation was that the normal offspring can be preceded and followed by an infected sibling.