In most of the cases in which children present clinical stigmas of congenital syphilis together with a positive reaction to a serologic blood test, the mother also has a positive reaction. If, however, the mother's reaction is negative on repeated examinations, there are several possible explanations. The child may not have had a prenatal infection, or the mother may have been previously infected but have experienced a spontaneous cure by the time of examination. Again, the use of penicillin or other antibiotics for a nonsyphilitic infection may have caused a reversal of the serologic reaction with or without a clinical cure. The case described here illustrates such a diagnostic problem. The significance of this case is apparent when it is considered against the background of medical practice in this antibiotic era.
The use of penicillin in the treatment of gonorrhea and syphilis since 1943 has revolutionized the clinical management of
Fiumara NJ, Hill W. CONGENITAL SYPHILIS IN THE ABSENCE OF POSITIVE SEROLOGY IN THE MOTHERA THIRD INDICATION FOR THE TREPONEMA PALLIDUM IMMOBILIZATION TEST. JAMA. 1957;163(12):1037–1039. doi:10.1001/jama.1957.82970470001008
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