Congenital syphilis is a serious infection passed from an infected mother to her baby during pregnancy or delivery. It can cause severe illness, long-term disability, or even be fatal. About one third of babies born to syphilis-infected mothers may have congenital syphilis, one third are healthy, and one third may face adverse pregnancy outcomes.
If your baby is experiencing these symptoms, you can get personalised advice from licensed doctors through Hope Plus. This premium service helps you get timely care and avoid complications.
Key Takeaways
- Congenital syphilis occurs when a baby is infected by Treponema pallidum from the mother.
- Early detection and treatment are critical to prevent serious complications.
- Babies may show symptoms weeks to months after birth, while some may appear healthy initially.
- Pregnant women should be routinely screened and treated to prevent transmission.
Causes
- Treponema pallidum, the bacteria that causes syphilis.
Symptoms
Early congenital syphilis (6-8 weeks after birth):
- Nasal discharge or “snuffles”
- Blisters on palms and soles
- Enlarged liver and spleen
- Pallor or anaemia
- Joint swelling with or without limited movement
- Skin lesions
These early signs are often non-specific and may be missed without medical evaluation.
Late congenital syphilis (after 2 years):
- Small head size (microcephaly)
- Flattened nasal bridge, arched palate, or perforated nasal septum
- Poor growth or failure to thrive
- Developmental delays or intellectual disability
- Musculoskeletal abnormalities
Investigations
Testing is ideally done for the mother during pregnancy using:
- VDRL or RPR tests
- TPHA test
Treatment
For babies suspected of congenital syphilis (assuming possible cerebrospinal involvement in infants under 2 years):
- Aqueous benzylpenicillin 150,000 IU/kg IV every 12 hours for 10 days is prescribed and administered by healthcare providers.
- Procaine penicillin 50,000 IU/kg IM daily for 10 days may be used as an alternative.
Treatment for parents:
- Both parents are treated with benzathine penicillin 2.4 million IU IM, half in each buttock.
Important Notes:
- Infants whose mothers had untreated syphilis or started treatment within 30 days of delivery are assumed to have congenital syphilis.
- If syphilis is diagnosed during pregnancy, benzathine penicillin is preferred because erythromycin does not cross the placenta effectively.
- Doxycycline should never be used in pregnancy.
Prevention
- Routine screening and treatment of pregnant women for syphilis at antenatal clinics is essential to prevent congenital infection.
