Congenital syphilis is an infection in newborn and infants transmitted from pregnant mother who is suffering from syphilis. The mode of transmission from mother to fetus is through placental route. Syphilis is caused by Treponema pallidum, a spirochaete which is pathogenic only to humans.
Congenital syphilis is a serious infection which leads to many birth defects and neonatal deaths. At least half of the children who are infected with syphilis when they are in the womb die before or soon after their birth. The rest of infants born alive will have the disease.
Usually the symptoms in new born develop between the second and sixth week of life. Manifestation at birth is an indication of severe infection. Sometimes the symptoms may appear later in childhood. Treatment of syphilitic pregnant women considerably reduces risk of congenital syphilis in infants. Penicillin is the drug of choice for treating congenital syphilis.
Symptoms Of Congenital Syphilis In Infants
Symptoms and signs of congenital syphilis can appear soon after birth or at later stage in life. The condition is grouped under two stages, early congenital syphilis and late congenital syphilis. Below are the signs and symptoms of these two stages.
Early congenital syphilis:
The symptoms present within first 2 years of life. They are much more severe involving many organs of the body. Untreated, it results frequently in death.
- Nasal symptoms: Running nose is first to appear. The nasal lining becomes thick and swollen. There is profuse discharge of mucopurulent (yellowish) discharge which excoriates the upper lip. Ulcers inside the nose develop which may often bleed. The nasal bridge is flat (saddle nose).
- Skin: Eruptions on skin are common in early congenital syphilis. The rash begins in palms and soles. It is a non itchy, circular and slightly elevated rash. At first, it is bright red but later on fades to copper brown. The eyebrows are often involved with scaly eruptions and complete loss of hair. There are transverse ridges on nails. The rash has a tendency to wax and wane.
- Lesions on mucus membrane: Appearance of rash around the mouth, anus and vulva. Bleeding and fissures around them are common. Wart like condylomas occurs around anus and female genitals.
- Anemia: Anemia is always present and it may be due to suppression in bone marrow or from hemorrhage from nose.
- Hepatosplenomegaly: Liver and spleen are enlarged. There is slight amount of jaundice, which with anemia, swelling and stains left after eruptions produces a dirty, whitish brown appearance of the child.
- Neurosyphilis: The infection in infants can affect the brain leading to various symptoms such as meningitis, convulsion, hydrocephalous etc. With the involvement of the brain, at later stages children are mentally retarded and often suffer from convulsions and weakness on one side of the body.
- Teeth: The teeth decay early but otherwise show no specific deformity. However, the permanent teeth are mal-developed as the child grows.
- Radiological features: On x-ray examination, the epiphyses of knee, ankle and wrist appear wide. There is a jagged saw tooth appearance of epiphysis lining.
Late Congenital Syphilis Symptoms
They appear after the age of 2 years, but rarely after the age of thirty. Late congenital syphilis can affect cornea leading to a condition called interstitial keratitis. Increased secretions in the eyes, visual difficulty are few of its symptoms. The cornea gradually becomes opaque and reddish. Patient may become blind.
Neurosyphilis occurs between one to ten years of age. The child is mentally retarded and has convulsions. Arthritis may affect any of the large joint, but is common in knees. The joints are swollen due to collection of fluid in it.
The skin around the mouth, vagina and anus has permanent scarring. Patient may also suffer from hearing loss. Gummatous ulcers form in the nasal septum and hard palate in the mouth.
Stigmata: The child who has suffered from congenital syphilis is usually left with stigmas of the disease. He has flat nose, with a high forehead and a small nose with no bridge and a small mouth. He also has scars around the nose and mouth. The changes in the bones and skull become evident only as the child grows.
Treatment And Prevention Of Congenital Syphilis
Penicillin is the most effective drug used in treatment of any type of syphilis, which also includes congenital syphilis. According to the weight and age of child, pediatrician decides the dose that has to be given.
Congenital syphilis would rarely occur if proper preventive measures are taken. Every pregnant woman should undergo routine blood test for syphilis. It helps to identify the disease during pregnancy and with suitable treatment, the risk of congenital syphilis markedly decreases.
Secondly a safe sexual practice also helps to prevent syphilis.