Congenital Syphilis: Diagnosis & Treatment

Written by Medicover Team and Medically Reviewed by Dr Neha Mukhi , Pediatricians

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Congenital Syphilis is an infection that occurs when Treponema pallidum, the bacterium responsible for syphilis, is transmitted from an infected mother to her baby during pregnancy. This vertical transmission can result in severe health complications for the infant, including developmental delays, neurological disorders, organ damage, and even death if left untreated. Understanding the causes, transmission, diagnosis, treatment, and prevention of Congenital Syphilis is essential for improving maternal and newborn health.

What are the Causes of Congenital Syphilis?

Maternal Infection

The primary cause of Congenital Syphilis is untreated or inadequately treated maternal syphilis during pregnancy. The infection can cross the placenta at any stage of pregnancy, with the highest risk occurring during the primary and secondary stages of maternal infection.

Lack of Prenatal Care

Failure to receive regular prenatal care and routine syphilis screening significantly increases the risk of transmission. Early diagnosis and prompt treatment during pregnancy can effectively prevent Congenital Syphilis.

What are the Symptoms of Congenital Syphilis?

Early Congenital Syphilis

Symptoms appearing during the first two years of life may include:

Skin rashes.
Persistent nasal discharge (snuffles).
Enlarged liver and spleen (hepatosplenomegaly).
Jaundice.
Anemia.
Bone abnormalities.

Late Congenital Syphilis

Symptoms developing after two years of age may include:

Hutchinson teeth (notched, peg-shaped teeth).
Saddle nose deformity.
Frontal bossing.
Intellectual disability.
Hearing loss.
Vision problems.

When to See a Doctor for Congenital Syphilis?

Congenital Syphilis is a serious bacterial infection that is passed from an infected mother to her baby during pregnancy or childbirth. Without prompt treatment, it can affect multiple organs and lead to severe complications involving the bones, brain, eyes, ears, liver, and other vital organs. Early diagnosis and treatment are essential to prevent long-term health problems.

If your newborn or infant shows signs of Congenital Syphilis or was born to a mother diagnosed with syphilis during pregnancy, consult a Pediatrician for a comprehensive evaluation and specialized care.

Persistent skin rash, especially on the palms and soles.
Persistent nasal discharge (snuffles).
Yellowing of the skin or eyes (jaundice).
Enlarged liver or spleen.
Poor feeding or failure to gain weight.
Fever, irritability, or excessive crying.
Bone pain, swelling, or reduced movement of the limbs.
Hearing or vision problems.
Developmental delays or neurological symptoms.
A newborn born to a mother with untreated or inadequately treated syphilis during pregnancy.

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How is Congenital Syphilis Diagnosed?

Maternal Testing

Diagnosis begins with routine prenatal screening. Pregnant women should undergo syphilis testing during the first prenatal visit and again during the third trimester or at delivery if they are at high risk. Screening commonly includes Rapid Plasma Reagin (RPR) testing followed by confirmatory treponemal tests.

Infant Testing

Babies born to mothers with syphilis require a detailed clinical evaluation and laboratory investigations.

Physical examination.
Serological tests (RPR or VDRL).
Dark-field microscopy of suspicious lesions or body fluids.
X-rays of long bones.

How is Congenital Syphilis Treated?

Penicillin Therapy

Penicillin is the treatment of choice for Congenital Syphilis. Intravenous aqueous crystalline penicillin G or intramuscular procaine penicillin G effectively treats the infection and prevents serious complications when administered early.

Follow-Up and Monitoring

Regular follow-up with repeat blood tests and clinical examinations is essential to confirm successful treatment and detect any recurrence or delayed complications.

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How can Congenital Syphilis be Prevented?

Prenatal Screening and Treatment

Routine prenatal screening and early treatment of pregnant women with syphilis are the most effective methods of preventing Congenital Syphilis.

Education and Awareness

Educating expectant mothers about prenatal care, sexually transmitted infections, and the importance of timely treatment helps reduce the risk of transmission.

Partner Notification and Treatment

Testing and treating sexual partners help prevent reinfection and reduce the spread of syphilis within the community.

What are the Complications of Congenital Syphilis?

Neurological Complications

Untreated Congenital Syphilis can lead to serious neurological disorders.

Developmental delays.
Intellectual disability.
Seizures.
Hydrocephalus.

Musculoskeletal Complications

The infection can affect bones and joints, leading to structural abnormalities.

Osteochondritis.
Periostitis.
Saber shins.

Cardiovascular Complications

Late Congenital Syphilis may also affect the cardiovascular system.

Aortitis.
Aneurysms.
Myocarditis.

How is Congenital Syphilis Transmitted?

In Utero Transmission

Congenital Syphilis is most commonly transmitted during pregnancy when Treponema pallidum crosses the placenta and infects the developing fetus. Transmission can occur at any stage of pregnancy and is more likely when maternal infection is untreated.

Perinatal Transmission

Less commonly, transmission may occur during childbirth if the mother has active syphilitic genital lesions, exposing the newborn to the infection during delivery.