Congenital syphilis

This week on our series on TORCH infections, we are discussing syphilis, an increasingly prevalent disease in the pediatric population.

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This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Elizabeth Partridge. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

-Most congenital syphilis is asymptomatic. Less commonly will present with rash, snuffles, hepatosplenomegaly, anemia, and jaundice.

-Untreated disease can cause neurosyphilis and bone defects

-Compare mother's RPR titers to baby's and look for findings consistent with syphilis.

-Workup is based on whether mother was adequately treated and includes CBC, LP, skeletal survey, and LFTs.

-Treatment is with IV penicillin G for 10 days.

Sources:

AAP Red Book Syphilis chapter

Sankaran D, Partridge E, Lakshminrusimha S. Congenital Syphilis-An Illustrative Review. Children (Basel). 2023 Jul 29;10(8):1310. doi: 10.3390/children10081310. PMID: 37628309; PMCID: PMC10453258.

Fang J, Partridge E, Bautista GM, Sankaran D. Congenital Syphilis Epidemiology, Prevention, and Management in the United States: A 2022 Update. Cureus. 2022 Dec 27;14(12):e33009. doi: 10.7759/cureus.33009. PMID: 36712768; PMCID: PMC9879571.

https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf