title: Neonates at risk for congenital syphilis:  radiographic and cerebrospinal fluid evaluations.
abstract: OBJECTIVE
  To review the infants at risk for congenital syphilis (CS) and determine the optimal use of evaluations such as cerebrospinal fluid (CSF), the venereal disease research laboratory (VDRL) test, and long bone radiography studies.
  
  
  METHODS
  A retrospective chart review of all of the infants at risk for CS from January 1997 to December 2002 at the Regional Medical Center at Memphis was conducted. Subjects were identified from a database of prenatal maternal records. Infant charts showing a diagnosis of presumptive CS were reviewed and data were collected.
  
  
  RESULTS
  Of the 24,245 deliveries, maternal serology (rapid plasma reagin and microhemagglutination for treponemal antibody) was reactive in 250 women during pregnancy. Of 92 infants with a presumptive diagnosis of syphilis, only 2 (2.1%) were symptomatic. CSF examination for VDRL was feasible in 74 (80%) of the 92 infants. Only 1 (1.35%) of the 74 infants had a positive CSF-VDRL. Three infants had radiographic changes that were consistent with CS.
  
  
  CONCLUSIONS
  The burden of syphilis in pregnancy remains high. Proper evaluation of neonates is important in preventing long-term consequences. The frequency of positive CSF and long bone radiography studies remains low. These evaluations should be made based on the symptoms and plan of treatment for individual neonates.
authors.affiliation: Departments of Pediatrics and Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee, USA. atalati@uthsc.edu
authors.forename: Ajay J
authors.initials: AJ
authors.lastname: Talati
authors.forename: Padmaja
authors.initials: P
authors.lastname: Koneru
mesh_terms: D001842:Bone and Bones / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009494:Neurosyphilis / Q000134:cerebrospinal fluid / Q000151:congenital / Q000175:diagnosis; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D013588:Syphilis Serodiagnosis; D013590:Syphilis, Congenital / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000000981:diagnostic imaging