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Archivos de Pediatría del Uruguay

On-line version ISSN 1688-1249


MORAES, Mario; CAMACHO, Silvana; MARGNI, Carla  and  BORBONET, Daniel. Utilidad del examen de líquido cefalorraquídeo y de la radiografía de huesos largos en neonatos asintomáticos con riesgo de sífilis connatal. Arch. Pediatr. Urug. [online]. 2013, vol.84, n.3, pp.187-192. ISSN 1688-1249.

Summary  Introduction: there is limited information on the usefulness of the analysis of cerebrospinal fluid (CSF) and long bone radiography in identifying congenital syphilis in asymptomatic children. The group study attempts to assess the utility of such studies, considering their performance and cost as health policy. Objectives: to determine the prevalence of altered CSF analysis and long bone radiography in asymptomatic newborns at risk of congenital syphilis. Material and methods: we carried out an analytical and prospective study in the year 2010. It included term infants with a diagnosis asymptomatic syphilis. Results: The sample consisted of 61 newborns and their mothers. The average maternal age was 26 years, standard deviation (SD) 6,8. VDRL maternal titles ranged from nonreactive to 1/64 and in the umbilical cord blood from nonreactive to 1/128. Of all pregnancies, 49,2 % (30/61 ) were well controlled, considering the same as five or more controls, 29,5 % (18/61) poorly controlled and 21,3% (13/61) without control. In six of the 61 patients (9,83%) was identified cocaine or cannabis. In 53 newborns lumbar punctures were performed for CSF study, of which 10 were in white, and traumatic in 21 (58,5%). Neither study showed alterations in CSF cytochemical analysis. It obtained a single positive VDRL in CSF,which resulting of a traumatic puncture. There were a total of 54 long bone radiographs. Reported periostitis in only one case. Conclusion: in asymptomatic newborns at risk of congenital syphilis, the low incidence of neurosyphilis and low CSF examination performance,added to the high proportion of traumatic and white lumbar punctures question its usefulness currently based on the criteria established as a standard method of evaluation. Not obtained strong evidence for the indication of the long bone radiography as routine method assessment in asymptomatic newborns.


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