Congenital syphilis

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Antibodies

Congenital syphilis

Alternative Names:

Congenital lues; Fetal syphilis
Symptoms:

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NEWBORN

Irritability
Failure to gain weight or failure to thrive
Watery discharge from the nose
Early rash -- small blisters (vesicles) on the palms and soles
Later rash -- copper-colored, flat or bumpy (maculopapular) rash on the face, palms, soles
Rash at the junction of the skin and mucus membranes of the mouth, genitalia, and anus
No bridge to nose (saddle nose)
Severe congenital pneumonia, referred on an x-ray as "whiteout" or pneumonia alba

OLDER INFANT AND YOUNG CHILD

Bone pain
Refusal to move a painful extremity
Saber shins (bone abnormality of the lower leg)
Joint swelling (joint effusion)
Abnormal teeth (notched and peg shaped -- called Hutchinson teeth)
Scarring of the skin around earlier lesions on the mouth, genitalia, and anus (called rhagades)
Visual loss
Clouding of the cornea
Decreased hearing or deafness
Gray, mucous-like patches on the anus and outer vagina (condyloma lata)

There may be a history of syphilis in the expectant mother.
Signs and tests:

The physical examination may show signs of bone inflammation (periosteal elevations or osteochondritis). There may be evidence of hepatomegaly (enlarged liver) and splenomegaly (enlarged spleen).

Tests on the mother may include:

VDRL
FTA-ABS (fluorescent treponemal antibody test)

If the disorder is suspected at the time of birth, the placenta will be examined for signs of syphilis.

For an older infant or child, tests may include:
- Serologic test for syphilis (VDRL and FTA-ABS)
- Lumbar puncture to look for evidence of syphilis in the brain and central nervous system
- Eye examination by an ophthalmologist
- Microscopy, dark field examination (demonstrates Treponema pallidum)
- X-ray of the bones