Case report of a pregnant woman with syphilis treated with acetylspiramycin

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  • アセチルスピラマイシンで加療した妊娠梅毒の1例
  • アセチルスピラマイシン デ カリョウ シタ ニンシン バイドク ノ 1レイ

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Abstract

<p>We report the case of a pregnant woman infected with syphilis who was treated with acetylspiramycin because of drug eruption caused by penicillin antibiotics. The patient was a 19-year-old nulliparous woman. At 10 weeks of gestation, both the rapid plasma reagin test (RPR) and Treponema pallidum hemagglutination test (TPHA) were positive. A quantitative test for syphilis at 12 weeks of gestation revealed high levels of RPR (64-fold) and TPHA (20,480-fold). The diagnosis of asymptomatic syphilis was made. The time of infection was unknown. Amoxicillin at 1500 mg/day was started at 12 weeks of gestation. She developed drug rash eight days after starting the medication. Acetylspiramycin was administered for eight weeks starting at 15 weeks of gestation. After oral administration, the RPR titer decreased and she was considered cured. She delivered a healthy male baby at 41 weeks of gestation. The newborn had no signs of congenital syphilis. In this case, acetylspiramicyn was effective in preventing congenital syphilis. However, data are insufficient to recommend acetylspiramycin for the treatment of maternal infection and prevention of congenital syphilis. Therefore, further studies are necessary to determine alternative treatments to penicillin for pregnant women with syphilis in the case of penicillin allergy. [Adv Obstet Gynecol, 74 (3) : 399-403, 2022 (R4.8)]</p>

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