MyMedR

A case series with literature review on adjunctive usage of intravitreal ceftazidime in ocular syphilis with human immunodeficiency virus infection

Lim YW, Lott PW, Mohamad NF, Begam Iqbal T

Int J STD AIDS, 2021 09;32(10):968-973.

PMID: 33969754 DOI: 10.1177/09564624211011917

BACKGROUND: Penicillin is the conventional treatment for all stages of syphilis, including ocular and neurosyphilis, according to the recommendations by the Centre for Disease Control and Prevention Sexually Transmitted Disease. This case series highlighted three cases of ocular syphilis which showed prompt treatment response as early as 24 h after the adjunctive intravitreal ceftazidime injection.

METHODS: Case Series.

RESULTS: In case 1, there was significant improvement in the vision and vitritis after 24 h of a single intravitreal ceftazidime injection. In case 2, the patient achieved his best vision after a total of three intravitreal injections in his left eye and one in his right eye. In case 3, there was a further resolution of perivascular sheathing and retinal haemorrhages seen 1 week after a single intravitreal ceftazidime injection.

CONCLUSION: The efficacy of intravitreal ceftazidime injection as a local adjunctive therapy in ocular syphilis treatment is noteworthy. It can be considered in cases which show suboptimal or slower treatment response despite early commencement of systemic penicillin to prevent devastating ocular sequelae.

Matched MeSH terms: Syphilis Serodiagnosis

Seroreactivity to syphilis in Malaysian blood donors and expectant mothers

Jegathesan M, Fan YH, Ong KJ

Southeast Asian J. Trop. Med. Public Health, 1975 Sep;6(3):413-8.

PMID: 1241163

Seroreactivity to syphilis is high among Malaysian blood donors and expectant mothers indicating a high degree of treponemal infection. Further epidemiological studies are required to ascertain what proportion of these could be syphilis and what porportion yaws. Blood donors hava a higher reactivity rate than expectant mothers, the reasons probably being soical. The titres obtained in the VDRL test appear to have a relation to FTA-ABS reactivity although this is not to say treponematosis can be excluded on the basis of low titre VDRL results.

Matched MeSH terms: Syphilis Serodiagnosis*

Serological screening for syphilis during pregnancy in a multiethnic Asian population

Goh TH, Ngeow YF

Asia Oceania J Obstet Gynaecol, 1989 Mar;15(1):67-70.

PMID: 2735843

Out of 14,841 women who were serologically examined for syphilis at the antenatal booking clinic, University Hospital, Kuala Lumpur in Malaysia, 1.78% were VDRL positive and 1.05% TPHA positive with significant differences between the Malays, Indians and Chinese. These rates are higher than published series and were attributed to childhood yaws infection among the Malays. As differentiation between yaws and syphilitic infection in the clinic is difficult, all TPHA-reactive women were treated as for syphilis. Congenital syphilis was not diagnosed in those women who had been effectively treated before delivery.

Matched MeSH terms: Syphilis Serodiagnosis*

The laboratory diagnosis of venereal diseases. I. Serological tests for syphilis

Jegathesan M

Med J Malaysia, 1973 Dec;28(2):109-12.

PMID: 4276225

Matched MeSH terms: Syphilis Serodiagnosis*

The influence of syphilis in South Indian estate women on foetal and infant mortality

Reed JG

Journal of the Malaya Branch of the British Medical Association, 1940;4:288-94.

Matched MeSH terms: Syphilis Serodiagnosis

THE VALUE AND MANAGEMENT OF PERSISTENT KAHN POSITIVE IN TREATED SYPHILIS

SAMBHI JS

Med J Malaysia, 1963 Sep;18:19-24.

PMID: 14064291

Matched MeSH terms: Syphilis Serodiagnosis*

Fulltext Malaysia’s success in eliminating mother-to-child transmission of HIV and syphilis

Mohd Nasir Abd Aziz

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):24-24.

MyJurnal

Introduction: HIV and syphilis testing has been part of Malaysia’s comprehensive maternal & child health pro-gramme for more than 2 decades. Part of this antenatal package include lifelong antiretroviral (ARV) treatment to HIV+ pregnant women, free antiretroviral therapy (ART) prophylaxis/ infant formula for all HIV-exposed infants and appropriate management for syphilis positive antenatal mothers. The objective of this paper is to present the analysis of Malaysia’s achievement in obtaining the elimination of mother-to-child transmission of HIV (eMTCT) and syphilis status from the World Health Organisation (WHO). Methods: This survey is based on our surveillance and analysis of data on HIV and syphilis testing on pregnant women over a three-year period, beginning from 2015. Results: Malaysia’s national health survey revealed 97.4% of pregnant women in Malaysia had a minimum of four antenatal visits. The MOH’s surveillance system also showed 95.1% and 95.8% of pregnant women received HIV/ syphilis screening in 2015 and 2016 respectively, whilst the HIV vertical transmission rate declined from 16.12% in 2000 to 2.46% and 1.99% in 2015 and 2016 respectively. Congenital syphilis rates declined from 6.0 / 100,000 live births in 2012 to 5.0 and 4.0/ 100,000 live births in 2015 and 2016 respectively. In addition, more than 95% of antenatal mothers living with HIV received ARV and almost 100% of TPHA positive (Treponema pallidum haemagglutination) of expectant mothers received appropriate treatment. Conclusion: Based on such impressive findings, Malaysia was recognised by WHO in May 2018 as the first country in the Western Pacific Region to have successfully “eliminated” a significant public health problem.

Matched MeSH terms: Syphilis Serodiagnosis

An epidemiological study of syphilis and predictors of treatment failure in University Malaya Medical Centre

Mohamed AK, Raja IA, Rukumani DV

Med J Malaysia, 2020 05;75(3):199-203.

PMID: 32467532

INTRODUCTION: There are limited studies on the epidemiology of syphilis in Malaysia. In this study we describe the clinical features and treatment outcomes of patients with syphilis attending a tertiary referral university hospital.

METHODS: We retrospectively reviewed the case records of patients with positive serology findings for syphilis in University Malaya Medical Center (UMMC) from January 2010 to December 2015. Serological positivity was defined as having a positive rapid plasma reagin (RPR) or Venereal Disease Research Laboratory (VDRL) with a confirmatory positive Treponema pallidum particle agglutination assay (TPPA). Treatment outcomes were divided into two, success or failure. Demographic and clinical characteristics associated with predictors of treatment failure were assessed using statistical package for the social science (SPSS). This study also included a neurosyphilis descriptive sub-study.

RESULTS: There were 637 patients identified with positive syphilis serology, but 258 patients were excluded as they did not meet the inclusion criteria. 379 patients were then taken for the demographic study; 14 patients (3.7%) were treated for neurosyphilis; 170 patients with complete data were included. In all 42/170 (24.7%) failed treatment, 12/170 (7.1%) had reinfection and 116/170 (68.2%) had treatment success. A final number of 158 patients were then taken and analyzed for predictors of treatment failure after excluding the 12 reinfection patients. Only low baseline RPR (<1:16) was found to be significant on multivariate logistic regression analysis (p value: 0.007, 95% CI: 1.42, 9.21).

CONCLUSION: Most of the patients were HIV positive and from the MSM (Men who have sex with Men) population. Low baseline RPR titre is a predictor of treatment failure.

Matched MeSH terms: Syphilis Serodiagnosis

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