Congenital syphilis

Alternative names:

congenital lues; fetal syphilis

Symptoms:

NEWBORN

• irritability
• failure to gain weight or failure to thrive
• bloody 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)

• 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 vulva (condyloma lata)

Signs and tests:

The physical examination may show signs of periostitis or osteochondritis (both of these are types of bone inflammation). There may be evidence of hepatomegaly (enlarged liver) and splenomegaly (enlarged spleen).

Tests:
Tests on the mother may include:

• VDRL
• FTA-ABS fluorescent treponemal antibody test

• serologic test for syphilis (VDRL and FTA-ABS)
• microscopy, dark field examination (demonstrates T. pallidum)
• X-ray of the bone(s)