Congenital Syphilis

At Children’s Hospital Boston, we understand that you may have a lot of questions when your child is diagnosed with congenital syphilis.

•           What exactly is it?

•           How did he get it?

•           What are potential complications in my child’s case?

•           What are the treatments?

•           Are there any possible side effects from treatment?

•           How will it affect my child long term?

We’ve tried to provide some answers to those questions here, and when you meet with our experts, we can explain your child’s condition and treatment options fully.

Background

Syphilis is most likely to be passed from a mother to her child if she is in the first or second stage of the disease, rather than the latent phase. If the mother is not treated, syphilis infects the baby more than 75 percent of the time.

• If the infection is left untreated, almost half of children infected before birth do not make it to term or die soon afterwards.
  • It’s essential to treat the condition early in the pregnancy, which is why your doctor will most likely order a syphilis screening at your first prenatal exam.

The majority of children born with syphilis do not show any physical symptoms of the disease until weeks or months after birth. If left untreated, however, syphilis becomes a severe and chronic illness that affects the neurological and cardiovascular systems.

Causes

Adults contract syphilis through sexual contact with another person who has the infection.

• The infection is spread by direct contact with a syphilis sore, which usually appears on the genitals, anus or rectum, but can also appear on the lips or in the mouth.

You cannot get syphilis through contact with a toilet seat, eating utensil, swimming pool or hot tub.

Symptoms

Most babies born with syphilis experience no immediate symptoms.

• However, symptoms can soon develop and should be treated as soon as possible to reduce long-term harm to your baby’s health.

Symptoms of congenital syphilis differ between newborns and older infants because the disease progresses from its secondary stage to its final phase:

Newborns

• failure to thrive
• irritability
• watery nasal discharge (“sniffles”)
• rash and lesions
  • early rash — small blisters on palms and soles of feet
  • late rash — copper-colored on palms, soles, and face
  • rash around mouth, genitalia, anus
• severe pneumonia

Older infants

• tooth abnormalities (notched and peg-shaped teeth)
• bone pain and abnormalities in lower leg
• neurological problems
• blindness
• deafness

Symptoms of congenital syphilis may resemble other skin conditions or medical problems, so it’s best to consult your physician as soon as possible if you notice that your baby seems to be suffering from any of these conditions.

Long-term outlook

If your child is treated early, there should be no serious consequences of syphilis. However, if treatment is delayed, your child may suffer some serious health problems as a result of the infection. For more information, see the Treatment and Care [LINK] tab.

Questions to ask your doctor

Many parents are concerned about syphilisand can have lots of questions about the condition and how it can affect their baby.

You may find it helpful to jot down questions as they arise—that way, when you talk to your doctor, you can be sure that all of your concerns are addressed.

Here are some questions to get you started:

• Should I get tested for syphilis?
• What can I do to prevent infection?
• I’m infected. Is there any way to prevent passing it on to my baby?
• What steps can we take if my baby does get infected?
• What’s the long-term outlook for a baby with syphilis?

Prevention

Syphilis is on the rise in the United States. Considering the potentially fatal effects syphilis can have on a fetus, here are some tips to reduce the likelihood of becoming infected:

• Be monogamous—if your partner is not infected, you have no risk of infection.
• Use a condom—a latex condom can help prevent the spread of the bacteria that causes syphilis.

And if you’re pregnant, your doctor will most likely suggest a screening for syphilis at your first prenatal exam to ensure that you have not been infected.

FAQ

Q: What is syphilis?

A: Syphilis is a sexually transmitted disease caused by the bacteria Treponema pallidum that can result in serious congenital conditions if contracted during prenatal development.

Q: Why is syphilis a problem?

A: Syphilis can be passed from a mother to her child. If the mother is not treated, syphilis infects the baby more than 75 percent of the time.

• If the infection is left untreated, almost half of children infected before birth do not make it to term or die soon afterwards.

Q: Is there any way to prevent infection?

A: Considering the potentially fatal effects syphilis can have on a fetus, here are some tips to reduce the likelihood of becoming infected:

• Be monogamous—if your partner is not infected, you have no risk of infection.
• Use a condom—a latex condom can help prevent the spread of the bacteria that causes syphilis.

And if you’re pregnant, your doctor will most likely suggest a screening for syphilis at your first prenatal exam to ensure that you have not been infected.

Q: How is syphilis diagnosed?

A: A simple blood test can determine if a mother or her child has syphilis.

• If you are pregnant and know that you’ve been exposed to syphilis, ask your doctor to perform a test.

For older infants, in whom the disease has progressed, an eye exam, bone x-ray or spinal tap can detect the presence of syphilis in the eyes, bones or brain and central nervous system, respectively.

Q: What symptoms might my baby have?

A: Most babies born with syphilis experience no immediate symptoms.

• However, symptoms can soon develop and should be treated as soon as possible to reduce long-term harm to your baby’s health.

Symptoms of congenital syphilis differ between newborns and older infants because the disease progresses from its secondary stage to its final phase:

Newborns

• failure to thrive
• irritability
• watery nasal discharge (“sniffles”)
• rash and lesions
  • early rash — small blisters on palms and soles of feet
  • late rash — copper-colored on palms, soles, and face
  • rash around mouth, genitalia, anus
• severe pneumonia

Older infants

• tooth abnormalities (notched and peg-shaped teeth)
• bone pain and abnormalities in lower leg
• neurological problems
• blindness
• deafness

Symptoms of congenital syphilis may resemble other skin conditions or medical problems, so it’s best to consult your physician as soon as possible if you notice that your baby seems to be suffering from any of these conditions.

Q: What are our treatment options?

A: Here at Children’s, physicians in our Division of Infectious Diseases treat congenital toxoplasmosis in infants.

At all stages of the disease, the preferred treatment is penicillin. If you’re allergic to penicillin, your doctor can put you on what is called a desensitization program, which involves taking the medicine gradually in a controlled setting.

If your baby is born with syphilis, we’ll begin a penicillin treatment right away.

For more information, see the Treatment and Care [LINK] tab.

Q: What is my child’s long-term outlook?

A:If your child is treated early, there should be no serious consequences of syphilis. However, if treatment is delayed, your child may suffer some serious health problems as a result of the infection.

Q: What makes Children’s different?

A: Our physicians are expert, compassionate and committed to focusing on the whole child, not just his condition—that’s one reason we’re frequently ranked as a top pediatric hospital in the United States.

Physicians and researchers in our Division of Infectious Diseases are constantly learning more about how diseases develop and spread as well as how the body uses its defenses to fight back. 

And at Children’s, we consider you and your child integral parts of the care team and not simply recipients of care. You and your care team will work together to customize a plan of care for your child.