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The Northern Territory Disease Control Bulletin



The Northern Territory Disease Control Bulletin


Territory Health Services, Centre for Disease Control


Northern Territory disease control bulletin; E-Journals; PublicationNT; Northern Territory disease control bulletin






Date:1998-12; This publication contains may contain links to external sites. These external sites may no longer be active.; Made available via the Publications (Legal Deposit) Act 2004 (NT).




Communicable diseases; Reporting; Northern Territory; Statistics; Periodicals

Publisher name

Northern Territory Government

Place of publication



Northern Territory disease control bulletin


v. 5 no. 4

File type





Attribution International 4.0 (CC BY 4.0)

Copyright owner

Northern Territory Government



Parent handle


Citation address


Page content

The Northern Territory Disease Control Bulletin Vol. 5 No. 4 December 1998 13 Infant RPR 4 times mothers titre Management of suspected congenital syphilis The following are summarised in flow charts in the guidelines (not shown here). 1. Categorise neonatal risk status A. No risk Maternal perinatal RPR negative. B. Low Risk Any one of the following: Maternal syphilis in pregnancy with adequate treatment completed prior to 30 days before delivery with no possibility of reinfection after treatment Maternal perinatal RPR 1:4 and past history of adequately treated syphilis No maternal antenatal care (NB evaluate carefully to ensure infant is not high risk) C. High risk Maternal RPR positive and any one or more of the following: Treatment of the mother absent or inadequate Maternal treatment not completed 30 days before delivery Maternal reinfection post-treatment likely (eg partner not treated) Maternal RPR 1:8 at delivery Mother/infant highly likely to be lost to follow up Mother treated with non-penicillin regimen Clinical, radiological or CSF exam of infant strongly suggestive of syphilis Infant RPR 4 times titre of mother Positive darkground microscopy of fetal/placental tissue 2. Investigate and treat appropriately A. No risk No investigations/treatment B. Low risk Examine for clinical signs Check RPR/TPPA. If RPR 4 times mothers, go to high risk Enter name in Congenital Syphilis Register Administer benzathine penicillin 50,000 units/kg IM single dose. Follow-up at six months of age with venous RPR C. High Risk Examine for clinical signs Check RPR/TPPA, FBE, LFT Long bone X-rays Lumbar puncture only if facilities available Enter name in Congenital Syphilis Register If all above are negative, treat as for low risk (as above) If any of above are positive, administer benzyl penicillin 50,000 units/kg/dose IV 12 hourly for 10 days Follow-up at six months of age with venous RPR. LP only if previous LP suggested neurosyphilis 3. Notify Syphilis Register All low and high risk babies should be notified to the Register. This is done by photocopying and filling in the notification sheet at the back of the guidelines (shown on page 17 of this Bulletin) and sending it via internal mail to Community Paediatrician, CDC Darwin. The information is required so that: The relevant district medical officer (DMO)/local medical officer/Clinic can be informed in writing of the time of each review, and to estimate numbers of children requiring treatment each year. To ensure adequate treatment of the mother has taken place. To monitor low risk babies to see whether follow-up of this group is necessary. 4. Arrange adequate follow-up Follow-up should be ensured prior to discharge by: Notifying the DMO/doctor caring for the mother and infant in writing and specifying the six month follow-up on the discharge summary.

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