Placenta Non Grata: A Rare Presentation of a Reemerging Disease.
Dhu'l-Kifl Franklin, Stephen Gocke, Douglas Juarez et al.
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Case in brief
A 28-year-old pregnant woman in her third trimester presented to an emergency department with symptoms suggestive of sepsis, including abdominal cramping, fever, and altered mental status. She had no prenatal care and a history of homelessness and substance use. Following emergent delivery due to fetal distress, she was diagnosed with maternal syphilis and congenital syphilis in the neonate, with histopathologic analysis revealing spirochete invasion consistent with syphilitic chorioamnionitis.
Diagnostic / clinical pearl
Emergency physicians should maintain a high index of suspicion for syphilis in pregnant patients, especially those without prenatal care, as standard treatments for chorioamnionitis may not address this infection.
Why it matters
As maternal syphilis rates rise, emergency departments must be vigilant in recognizing and testing for this infection to prevent serious maternal and fetal complications.