Congenital Syphilis

The manifestations of congenital syphilis are variable and include asymptomatic disease, spontaneous abortion, intrauterine growth restriction, neonatal disease, and neonatal death.

The fetus is usually infected transplacentally, and congenital infection rarely occurs before the fourth month of gestation. Congenital infection is most likely to be acquired in the setting of maternal early syphilis; however, it has been documented at any stage of syphilis. Some of the classic features of neonatal disease include rhinitis (snuffles), which typically occurs early in the course of the disease, as well as rash, hepatitis, splenomegaly, and perichondritis or periostitis. Untreated neonates who survive neonatal syphilis enter a latent period. The perichondritis and periostitis can lead to deformities of the nose (saddle nose) and of the metaphyses of the lower extremities (saber shin). Other late manifestations of congenital syphilis include peg-shaped central incisors (Hutchinson’s teeth), frontal bossing, and recurrent arthropathy (Figure 60-9).

Prevention and early detection of congenital syphilis depend on routine screening of pregnant women for syphilis. All pregnant women should be screened at the first prenatal visit. Women who are at high risk for syphilis infection should be screened again in the third trimester and at delivery (see diagnostic approach).

  • Contact
  • Category: Infectious diseases