Diagnosis of congenital syphilis by combining Treponema pallidum-specific IgM detection with immunofluorescent antigen detection for T. pallidum.
Most infants at risk for congenital syphilis can be identified easily by a positive maternal serologic test for syphilis. However, a diagnosis of congenital syphilis can be difficult to make in an individual infant. Seven infants with delayed-onset congenital syphilis and 101 newborns at risk for congenital syphilis were evaluated for characteristic physical findings and laboratory-detectable abnormalities of congenital syphilis. By using a combination of Western blot for T. pallidum-specific IgM detection and immunofluorescent antigen detection for the identification of T. pallidum, a diagnosis of congenital syphilis was made in all 7 infants with delayed-onset congenital syphilis and 24 of the 101 newborns at risk for congenital syphilis. However, T. pallidum-specific IgM was negative in 6 of the 24 newborns with congenital syphilis. T. pallidum-specific IgM detection alone is inadequate for the diagnosis of congenital syphilis.
Department of Pediatrics, Children's Medical Center of Brooklyn, New York 11203.
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K
Bromberg
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S
Rawstron
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G
Tannis
D000907:Antibodies, Bacterial / Q000032:analysis; D000942:Antigens, Bacterial / Q000032:analysis; D015153:Blotting, Western; D005455:Fluorescent Antibody Technique; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D007231:Infant, Newborn; D013588:Syphilis Serodiagnosis / Q000379:methods; D013590:Syphilis, Congenital / Q000175:diagnosis*; D014210:Treponema pallidum / Q000276:immunology*
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D007075:Immunoglobulin M