Acquired Syphilis by Nonsexual Contact in Childhood

MOSCATELLI, GUILLERMO; MORONI, SAMANTA; GARCÍA BOURNISSEN, FACUNDO; FALK, NICOLÁS; DESTITO, ALEJANDRA; GONZÁLEZ, NICOLÁS; BALLERING, GRISELDA; D?AMICO, INDIRA; GARCÍA, LUCIANA; ALTCHEH, JAIME

PEDIATRIC INFECTIOUS DISEASE JOURNAL

LIPPINCOTT WILLIAMS & WILKINS

Año: 2021

0891-3668

Background: Children may acquire syphilis by nonsexual contact as a consequence of close and repetitive contact with mucosal or skin lesions ofpeople with active syphilis.Methods: Prospective cohort study of pediatric patients with acquiredsyphilis by nonsexual contact. Demographics, clinical findings, posttreatment serology development and general laboratory data were collected.Sexual transmission was ruled out after a careful medical and psychosocialevaluation of the patient and his/her family.Results: Twenty-four patients were included in the study. Mean age at diagnosis was 4.2 years old. All of them came from overcrowded householdswith poor hygiene conditions. The most frequent reason for consultationswas secondary syphilis skin lesions (79.2%). The psychosocial evaluationof children and their families did not reveal signs of sexual abuse in anyof the cases. Seventy-eight families and their cohabitants were evaluated,23 (29.5%) resulted positive for rapid plasma reagin and treponemal testof hemagglutination; 60.9% of the cases were asymptomatic. The symptomatic relatives showed lesions of secondary syphilis. A sustained fall onnontreponemal antibodies titer (rapid plasma reagin) was observed aftertreatment, becoming negative in 6/24 (25%) cases within 12 months posttreatment.Discussion: Following evaluation, it was considered that sexual abuse wasunlikely. However, if examination and psychosocial evaluation do not support it, other ways of transmission must be considered. Overcrowded andpoor household conditions boost the risks for nonsexual treponema transmission. An infected member of the family or a caretaker are a particularrisk to an infant due to common practices such as using saliva to moistenthe rubber nipples of the milk bottles or trying the food temperature usingthe lips before feeding the infants