Placental syphilis: a comprehensive review of routine histomorphology, HIV co-infection, penicillin treatment, immunohistochemistry, and polymerase chain reaction.
Date
2023-04
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Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH ABSTRACT: Introduction: Placental examination is useful to diagnose congenital syphilis. The classical histological diagnostic triad is, however, an infrequent finding. Additional morphological clues, special investigations, and knowledge of potential alterations by HIV co-infection and penicillin treatment can aid in making the diagnosis. Materials and methods: Placental specimens diagnosed with treponemal infection were reviewed. Morphological findings, IHC and qPCR results were assessed. Results: Two-hundred and twenty-two placentas were recruited. Villitis (93.2%), acute chorioamnionitis (91%) and villous immaturity (64%) were the most common abnormalities. HIV co-infection and penicillin treatment demonstrated alterations that may hamper diagnosis. Treponema IHC and q-PCR had a sensitivity of 74.4% and 25.81%, respectively and confirmed an additional 41 cases with negative or unknown serology. Conclusion: Villitis, acute chorioamnionitis and villous immaturity are the most common microscopic abnormalities in placental syphilis. HIV co-infection and penicillin treatment may alter morphology. Treponema IHC and q-PCR are useful adjuncts when serology is negative.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Description
Thesis (MMed)--Stellenbosch University, 2023.