ABSTRACT: In 2007, the WHO launched the global initiative to eliminate mother-to-child transmission of syphilis. According to the WHO data, an average of 1.5 million pregnant women develop syphilis each year due to lack of timely treatment. Goal: By presenting a clinical case - early latent syphilis in a pregnant woman, to outline current problems of syphilis management in pregnancy. Material and methods: Medical documentation of the Medical Center “Derma Guard”, Stara Zagora was investigated according with the principles of research ethics; analysis of normative documents and scientific publications was applied. Results: A case of a 21-year-old woman with a first pregnancy – first trimester, referred by an obstetrician with a positive Rapid Plasma Reagyn Test (RPR) was presented. Somatic status - without specifics; Dermatological status - no deviations. Examination revealed enlarged bilateral inguinal lymph nodes the size of a hazelnut, mobile, painless. Laboratory tests - hematological and biochemical - are in reference values. Serological tests for syphilis are the following: positive RPRT (Rapid Plasma Reagyn Test); specific TPHA test (Treponema Pallidum Haemagglutanation Assay) - positive /++/; ELISA positive /+ /; Anti HIV1 / 2 antibody test / - / negative. Therapy: Ceftriaxone 2.0 g: 2.0 g i.m.d. for 7 days; Neopholic 0.4 mg - 1t. daily p.o. Conclusions: We present the opportunities and challenges for improving the management of syphilis during pregnancy and especially for early screening and timely treatment and dispensary monitoring in the context of current normative regulations in Bulgaria aiming to avoid adverse birth outcomes.

Keywords: syphilis in pregnancy, congenital syphilis, sexually transmitted infections spectrum, mother-to-child transmition of syphilis

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