What is congenital syphilis?
Congenital syphilis (CS) is a disease that occurs when a mother with syphilis passes the infection on to her baby during pregnancy. CS can have major health impacts on your baby. How CS affects your baby’s health depends on how long you had syphilis and if — or when — you got treatment for the infection.
CS can cause:
- Miscarriage (losing the baby during pregnancy),
- Stillbirth (a baby born dead),
- Prematurity (a baby born early),
- Low birth weight
- Death shortly after birth.
Up to 40% of babies born to women with untreated syphilis may be stillborn, or die from the infection as a newborn.
How common is congenital syphilis?
Please discuss with your doctor for further information.
What are the symptoms of congenital syphilis?
Most babies who are infected before birth appear normal. Over time, symptoms may develop. In babies younger than 2 years old, symptoms may include:
- Enlarged liver and/or spleen (mass in belly)
- Failure to gain weight or failure to thrive (including prior to birth, with low birthweight)
- Irritation and cracking of skin around the mouth, genitals, and anus
- Rash starting as small blisters, especially on the palms and soles, and later changing to copper-colored, flat or bumpy rash
- Skeletal (bone) abnormalities
- Not able to move a painful arm or leg
- Watery fluid from the nose
Symptoms in older infants and young children may include:
- Abnormal notched and peg-shaped teeth, called Hutchinson teeth
- Bone pain
- Clouding of the cornea (the covering of the eyeball)
- Decreased hearing or deafness
- Deformity of the nose with flattened nasal bridge (saddle nose)
- Gray, mucus-like patches around the anus and vagina
- Joint swelling
- Saber shins (bone problem of the lower leg)
- Scarring of the skin around the mouth, genitals, and anus
It is possible that a baby with CS won’t have any symptoms at birth. But without treatment, the baby may develop serious problems. Usually, these health problems develop in the first few weeks after birth, but they can also happen years later.
Babies who do not get treatment for CS and develop symptoms later on can die from the infection. They may also be developmentally delayed or have seizures.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes congenital syphilis?
Congenital syphilis is caused by the bacteria Treponema pallidum, which is passed from mother to child during fetal development or at birth. Nearly one half of all children infected with syphilis while they are in the womb die shortly before or after birth.
All pregnant women should be tested for syphilis at the first prenatal visit (the first time you see your doctor for health care during pregnancy). If you don’t get tested at your first visit, make sure to ask your doctor about getting tested during a future checkup. Some women should be tested more than once during pregnancy. Talk with your doctor about the number of syphilis cases in your area and your risk for syphilis to determine if you should be tested again at the beginning of the third trimester, and again when your baby is born.
Keep in mind that you can have syphilis and not know it. Many people with syphilis do not have any symptoms. Also, syphilis symptoms may be very mild, or be similar to signs of other health problems. The only way to know for sure if you have syphilis is to get tested.
What increases my risk for congenital syphilis?
There are many risk factors for congenital syphilis, such as:
- Untreated syphilis in the mother
- Lack of proper maternal care
- Low socio-economic standards
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is congenital syphilis diagnosed?
If the infection is suspected at the time of birth, the placenta will be examined for signs of syphilis. A physical examination of the infant may show signs of liver and spleen swelling and bone inflammation.
A routine blood test for syphilis is done during pregnancy. The mother may receive the following blood tests:
- Fluorescent treponemal antibody absorbed test (FTA-ABS)
- Rapid plasma reagin (RPR)
- Venereal disease research laboratory test (VDRL)
An infant or child may have the following tests:
- Bone x-ray
- Dark-field examination to detect syphilis bacteria under a microscope
- Eye examination
- Lumbar puncture (spinal tap) – to remove spinal fluid for testing
- Blood tests (similar to those listed above for the mother)
How is congenital syphilis treated?
Babies who have CS need to be treated right away — or they can develop serious health problems. Depending on the results of your baby’s medical evaluation, he/she may need antibiotics in a hospital for 10 days. In some cases, only one injection of antibiotic is needed. Penicillin is the drug of choice for treating this problem. It may be given by IV or as a shot or injection. If the baby is allergic to penicillin, then it is given in very small dosages and in a controlled manner, until the body gets sensitized (accustomed) to the drug. Other antibiotics may be used if desensitization fails.
It’s also important that babies treated for CS get follow-up care to make sure that the treatment worked.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage congenital syphilis?
The following lifestyles and home remedies might help you prevent congenital syphilis:
- Being in a long-term mutually monogamous relationship with a partner who has been tested for syphilis and does not have syphilis.
- Using latex condoms the right way every time you have sex. Although condoms can prevent transmission of syphilis by preventing contact with a sore, you should know that sometimes syphilis sores occur in areas not covered by a condom, and contact with these sores can still transmit syphilis.
- All pregnant women should be tested for syphilis at the first prenatal visit (the first time you see your doctor for health care during pregnancy). If you don’t get tested at your first visit, make sure to ask your doctor about getting tested during a future checkup. Some women should be tested more than once during pregnancy. Talk with your doctor about the number of syphilis cases in your area and your risk for syphilis to determine if you should be tested again at the beginning of the third trimester, and again when your baby is born.Keep in mind that you can have syphilis and not know it. Many people with syphilis do not have any symptoms. Also, syphilis symptoms may be very mild, or be similar to signs of other health problems. The only way to know for sure if you have syphilis is to get tested.
If you are pregnant, and have syphilis, you can still reduce the risk of CS in your baby. Getting tested and treated for syphilis can prevent serious health complications in both mother and baby.
Prenatal care is essential to the overall health and wellness of you and your unborn child. The sooner you begin receiving medical care during pregnancy, the better the health outcomes will be for you and your unborn baby.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
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Congenital Syphilis. https://www.msdmanuals.com/professional/pediatrics/infections-in-neonates/congenital-syphilis. Accessed February 26, 2019.
Congenital Syphilis. https://rarediseases.org/rare-diseases/congenital-syphilis/. Accessed February 26, 2019.
Congenital Syphilis - CDC Fact Sheet. https://www.cdc.gov/std/syphilis/stdfact-congenital-syphilis.htm. Accessed February 26, 2019.
Review Date: February 26, 2019 | Last Modified: February 26, 2019