Syphilis Overview and Clinical Manifestations

A series of tests to identify possible congenital syphilis in infants, including CSF analysis, CBC, and blood tests.

Analysis of cerebrospinal fluid (CSF) to examine for signs of infection.

A blood test measuring the level of antibodies that indicate syphilis infection, compared to the mother's titer

X-ray imaging of long bones to look for abnormalities in syphilis infection.

Intravenous antibiotic used to treat congenital syphilis, given every 12 hours (younger infants) or every 8 hours (older), for 10 days.

Intramuscular antibiotic to treat congenital syphilis, given as a single daily dose for 10 days.

Intramuscular antibiotic for treatment of congenital syphilis, given in a single dose.

Critical information about the mother's syphilis treatment during pregnancy, including adequacy and type of treatment.

Antibiotic treatment for syphilis that is not penicillin.

Ongoing monitoring of infant infections, including testing, to ensure syphilis no longer exists.

A sonographic (ultrasound) evaluation of the fetus should be performed when syphilis is diagnosed in the mother during the second half of pregnancy.

After delivery, a pathologic examination of both the placenta and umbilical cord is recommended in cases of maternal syphilis.

Any woman who delivers a stillborn infant after 20 weeks' gestation should be tested for syphilis.

No newborn infant should be discharged from the hospital without determining the mother's serologic status for syphilis.

All infants born to mothers with positive syphilis serology require a thorough examination and a nontreponemal test.

The same type of serologic test used for the mother should be performed on the infant, allowing comparison of titer results.

A CSF examination, along with other tests, is recommended in infants with reactive syphilis serologic tests to diagnose congenital syphilis.

Infants born to mothers with both syphilis and HIV do not require specialized evaluation, therapy, or follow-up for syphilis.

A normal infant examination, combined with a serum nontreponemal titer less than or equal to fourfold the mother's titer, and a mother with adequate treatment before pregnancy, suggest congenital syphilis is improbable in the infant.

Benzathine penicillin G, 50,000 IU/kg IM, single dose, might be considered if follow-up is uncertain, and the infant has a reactive test (some experts).

A negative nontreponemal test at birth and a seroreactive mother at delivery suggest a need to retest in 3 months.

Mother's nontreponemal serologic titer that remains low and stable (serofast) before, during, and at delivery (e.g., VDRL ≤1:2; RPR ≤1:4) indicate decreased risk for congenital syphilis.

The condition where the mother's nontreponemal serologic titer shows stability and does not increase significantly

Treatment of the mother before pregnancy that effectively reduced the risk of transmitting syphilis to the infant.

A precise measurement of the level of nontreponemal antibodies in the blood.

Physical assessment of the newborn to determine their overall health, indicating potential signs of congenital syphilis.

A laboratory test that helps identify congenital syphilis by measuring if the genetic material of bacteria are present in the sample; Used as a supplementary test to the serological testing in the diagnosis of congenital syphilis.