Congenital lues
Key points
- Congenital syphilis is an infection caused by the spirochete Treponema pallidum (syphilis) passed from mother to child during fetal development or birth.
- An expectant mother who is infected with syphilis can transmit the disease through the placenta to the unborn infant.
- The physical examination may show signs of bone inflammation (periosteal elevations or osteochondritis).
- Many infants who were infected early in the pregnancy are stillborn.
Alternative names
Congenital syphilis; Fetal syphilis
Definition
Congenital syphilis is an infection caused by the spirochete Treponema pallidum (syphilis) passed from mother to child during fetal development or birth.
Causes, incidence, and risk factors
An expectant mother who is infected with syphilis can transmit the disease through the placenta to the unborn infant. Congenital syphilis is a severe, disabling, and often life-threatening condition for the infant. Nearly half of all children infected with syphilis during gestation die shortly before or after birth.
Infants who survive develop early-stage and late-stage symptoms of syphilis, if not treated. Early-stage symptoms include irritability, failure to thrive, and nonspecific fever. Some infants develop a rash and lesions (sores) on the borders of the mouth, anus, and genitalia (called condyloma lata).
Some of these lesions may resemble the wart-like lesions of adult syphilis. A small percentage of infants have a watery nasal discharge (sniffles) and a saddle nose deformity resulting from infection in the cartilage of the nose. Bone lesions are common, especially in the upper arm (humerus).
Later signs appear as tooth abnormalities (Hutchinson teeth), bone changes (saber shins), neurological involvement, blindness, and deafness. Despite the fact that this disease can be cured with antibiotics if caught early, rising rates of syphilis amongst pregnant women in the United States have recently increased the number of infants born with congenital syphilis.
Symptoms
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)
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.