Congenital Syphilis

Overview
  • Mother's infected with T. pallidum can transmit the infection to their fetus at any time during pregnancy in utero. Transmission can occur regardless of which clinical stage of syphilis the mother possesses, although the probability is much higher in mothers with Primary Syphilis or Secondary Syphilis. The timing of pathology in fetuses correlates with the development of the fetal immune response, suggesting that the pathogenesis is host immune-related.
Clinical Consequences
  • Spontaneous Abortion
    • Transmission of T. pallidum to the fetus significantly increases the risk of spontaneous abortion. In those who survive fetal life, different stages of clinical consequences progressively appear as described below.
  • Early Congenital Syphilis
    • Early congenital syphilis is apparent at or within weeks of birth. Many neonates possess a chronic rhinitis which is termed "snuffles" along with a skin rash similar to that observed in Secondary Syphilis. These neonates also display significant changes in bone morphology and frequently hepatosplenomegaly along with generalized lymphadenopathy.
  • Late Congenital Syphilis
    • Late Congenital Syphilis is apparent in individuals who have been left untreated for more than two years and resembles in some respects Tertiary Syphilis of adults. Neurological involvement often manifests as CN VIII deficits which cause deafness. Keratitis, or inflammation of the cornea can lead to blindness. Inflammation of bone's periosteum can lead to a number of morphological changes such as sinking in of the nose, resulting in a "Saddle Nose", or bowing of the tibia, resulting in "Saber Shins". Often, children display wide spacing of particular teeth, termed "Hutchinson's teeth" and their molars have extra cusps, termed "Mulberry Molars".