Congenital Syphilis v1

Query purpose: 

This definition is used to identify visits of congenital syphilis in patients ages 4 years old and younger. Congenital syphilis is a condition caused by infection with Treponema pallidum in utero or at the time of delivery. Please note that the queries are developed using congenital syphilis-related free text terms from chief complaint fields and congenital syphilis-related International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and ICD-10-CM discharge diagnosis codes as the basis for identifying patient visits of interest and not the Council of State and Territorial Epidemiologists (CSTE) congenital syphilis surveillance case definition. The queried patient visits may or may not represent data for a case patient included in National Notifiable Diseases Surveillance System (NNDSS) case data and further public health investigation may be required.

How it works:

The Chief Complaint Discharge Diagnosis (CCDD) parsed field is used to query both the discharge diagnosis codes and chief complaint free text, and exclusions are incorporated as necessary.

• Inclusion based on congenital syphilis complaint free text terms:
  • The visit is included if it contains:
    1. A chief complaint related to congenital syphilis – (“siphilis” or “syphylis” or “syphylus” or “syphilus” or “siphylis” or “siphilus” or “syphilis” or “siphillis” or “syphyllis” or “syphyllus” or “syphillus” or “siphyllis” or “siphillus” or “syphillis” or “sifilis” or “syfylis” or “syfylus” or “syfilus” or “sifylis” or “sifilus” or “syfilis”) OR
• Inclusion based on ICD-9 discharge diagnosis codes related to congenital syphilis:
  • The visit is included if it contains:
    1. A discharge diagnosis code related to early congenital syphilis – (090.0 or 090.10 or 090.2) OR
    2. A discharge diagnosis code for syphilitic interstitial keratitis – (090.30) OR
    3. A discharge diagnosis code related to neurosyphilis – (090.40 or 090.41 or 090.42 or 090.49) OR
    4. A discharge diagnosis code related to late congenital syphilis – (090.50 or 090.60 or 090.70) OR
    5. A discharge diagnosis code related to early syphilis – (091 or 092) OR
    6. A discharge diagnosis code for cardiovascular syphilis – (093) OR
• Inclusion based on ICD-10 discharge diagnosis codes related to Congenital Syphilis:
  • The visit is included if it contains:
    1. A discharge diagnosis code related to congenital syphilis – (A50 or A50.9) OR
    2. A discharge diagnosis code related to early congenital syphilis – (A50.0 or A50.01 or A50.02 or A50.03 or A50.04 or A50.05 or A50.06 or A50.07 or A50.08 or A50.09 or A50.1 or A50.2) OR
    3. A discharge diagnosis code related to late congenital syphilis - (A50.3 or A50.30 or A50.31 or A50.32 or A50.39 or A50.5 or A50.54 or A50.55 or A50.56 or A50.59 or A50.6 or A50.7 or A52) OR.
    4. A discharge diagnosis code related to late congenital neurosyphilis - (A50.4 or A50.40 or A50.41 or A50.42 or A50.43 or A50.44 or A50.45 or A50.49) OR
    5. A discharge diagnosis code for Clutton’s joints (A50.51) OR
    6. A discharge diagnosis code for Hutchinson’s teeth (A50.52) OR
    7. A discharge diagnosis code for Hutchinson’s triad (A50.53) OR
    8. A discharge diagnosis code for Syphilitic saddle nose (A50.57) OR
    9. A discharge diagnosis code for early congenital syphilis (A51) OR
    10. A discharge diagnosis code for Other and unspecified syphilis (A53) OR
• Inclusion based on SNOMED discharge diagnosis codes related to Congenital Syphilis:
  • The visit is included if it contains:
    1. A discharge diagnosis code related to congenital syphilis - (35742006 or 87318008 or 9941009 or 192008 or 27648007) OR
    2. A discharge diagnosis code related to early congenital syphilis - (4359001 or 186833000 or 266125005 or 721583004 or 46235002) OR
    3. A discharge diagnosis code for Hutchinson’s teeth - (86443005) OR
    4. A discharge diagnosis code related to late congenital neurosyphilis - (266126006 or 6267005
    5. A discharge diagnosis code related to late congenital syphilis - (82323002 or 827006 or 73551500 or 1142095003 or 1142031005 or 866106004 or 11142112002) OR
    6. A discharge diagnosis code for Moon’s molar teeth - (109436001) OR
    7. A discharge diagnosis code for Mulberry molar teeth - (1177081002) OR
    8. A discharge diagnosis code for syphilis in mother complicating childbirth - (10759921000119107) OR
    9. A discharge diagnosis code for pericellular fibrosis of congenital syphilis - (235898000) OR
    10. A discharge diagnosis code for hypoplasia of enamel due to congenital syphilis - (703134008) OR
    11. A discharge diagnosis code for congenital nephrotic syndrome due to congenital infection - (722118005)
• There are no exclusions in this query.

Plain language description:

The definition uses discharge diagnosis codes and free-text chief complaint terms. The definition requires that an emergency department visit contains a reference to the condition by its discharge diagnosis code (in at least one of the following: ICD-9-CM, ICD-10-CM, SNOMED diagnostic codes), or by the condition name listed in the chief complaint text. Therefore, the congenital syphilis v1 syndromic surveillance definition includes ICD-9-CM, ICD-10-CM, and SNOMED diagnostic codes for congenital syphilis, along with direct mentions of syphilis (including misspellings of syphilis) in chief complaint text. To ensure that only congenital syphilis was captured, we limit the visits to those in children ages 0-4.