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Congenital Syphilis
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Congenital Syphilis

Congenital Syphilis
TORCHeS infection
  • Maternal infection may present with primary ulcers or secondary rash.
  • Neonatal infection
– Stillbirth, Hydrops fetalis. – Can be asymptomatic.
Early congenital syphilis (first 2 years)
  • Rash on palms/soles of feet
  • Lymphadenopathy
  • Hepatosplenomegaly
  • Snuffles (nasal discharge, rhinitis)
  • Pseudoparalysis due to skeletal abnormalities (osteochondritis, metaphysitis, periostitis of long bones).
  • Long bone abnormalities:
– Wimberger’s sign (bilateral destruction of the proximal tibial metaphysis) – Sawtooth (serration) metaphyses (aka, Wegener sign) – Periostitis of diaphysis
  • Diagnosis
– Darkfield microscopy, CSF analysis
Late congenital syphilis
  • Hutchison Triad
– Hutchison teeth, interstitial keratinitis, sensorineural hearing loss
  • Facial deformities
– Gummatous ulcers (nose, septum, hard palate) – Perforation of hard palate – Rhagades (perioral fissures, cracks, or scars) – Frontal bossing (abnormally prominent forehead) – Mulberry molars
  • Skeletal abnormalities
– Saber shins (anterior bowing of tibia)
  • Neurologic complications
– Cranial nerve palsies – Intellectual disabilities
  • Diagnosis
– Serology
  • Treatment
– Penicillin
References & Image Credits
“Congenital Syphilis.” Wikipedia, April 29, 2018. https://en.wikipedia.org/w/index.php?title=Congenital_syphilis&oldid=838862112.
“Congenital Syphilis - Pediatrics.” Merck Manuals Professional Edition. Accessed September 11, 2018. https://www.merckmanuals.com/professional/pediatrics/infections-in-neonates/congenital-syphilis.
“Details - Public Health Image Library(PHIL).” Accessed September 11, 2018. https://phil.cdc.gov/Details.aspx?pid=3823.
NIH. Frontal Bossing. Accessed September 11, 2018. https://elementsofmorphology.nih.gov/index.cgi?tid=a223995bdef3e8d6.

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