Congenital syphilis

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Antibodies

Congenital lues; Fetal syphilis

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 of the mouth, genitalia, and anus
• No bridge to nose (saddle nose)
• Severe congenital pneumonia

• Bone pain
• Refusal to move a painful arm or leg
• Saber shins (bone problem of the lower leg)
• Joint swelling
• Abnormal teeth (notched and peg shaped -- called Hutchinson teeth)
• Scarring of the skin around the mouth, genitalia, and anus (rhagades)
• Vision loss
• Clouding of the cornea
• Decreased hearing or deafness
• Gray, mucous-like patches on the anus and outer vagina (condylomata)

The physical examination may show signs of bone inflammation, hepatomegaly (enlarged liver), and splenomegaly (enlarged spleen).

Tests on the mother may include:

• VDRL
• FTA-ABS (fluorescent treponemal antibody test)
• Rapid plasma reagin (RPR)

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:
  • Lumbar puncture
  • Eye examination
  • Microscopy, dark field examination
  • X-ray of the bones

Review Date: 09/29/2006
Reviewed By: Patrika M. Tsai, MD, MPH, Specialist in Pediatric Gastroenterology and Nutrition, Foster City, CA. Review provided by VeriMed Healthcare Network.