Congenital Syphilis

Syphilis is a systemic infection caused by Treponema pallidum, divided into acquired and congenital forms. Acquired (adult) syphilis is mainly sexually transmitted in 3 stages. Congenital (prenatal) syphilis is transplacental, causing stillbirth/preterm birth; pregnancy syphilis raises fetal risk 2.5× and perinatal mortality up to 50%. It severely affects infant health.

Common Symptoms

Macule; lymphadenopathy; papule; station doctor; pustule; roseola; mucosal lesion; pathologic jaundice; eschar; condyloma

Causes and Pathogenesis

T. pallidum readily crosses the placenta. It was historically thought to infect the fetus after the 4th month (when Langhans layer atrophies), but electron microscopy shows transplacental infection in all trimesters. Pathogenesis: universal susceptibility; mechanism unclear. After transplacental entry, treponemes multiply in fetal liver/spleen/adrenal and seed the blood, causing skin/mucosal/bone/blood/visceral lesions; severe cases cause abortion/preterm/stillbirth. Pathology: endothelial swelling/proliferation causing luminal occlusion, distal necrosis/caseous change, or fibrous scarring impairing organ structure/function.

Treatment

Drug therapy, supportive therapy

Preventive Measures

99% of adequately treated pregnancies cure both mother and fetus, but late treatment leaves residual signs. Routine prenatal STS, re-screening of mothers with other STDs, and treatment of infected women greatly reduce incidence. When congenital syphilis is diagnosed, all family members should be screened. Re-treat only if serology remains positive after another pregnancy; persistently positive women may be reinfected. Asymptomatic seronegative contacts of syphilis patients should be treated (25-50% chance of infection before seroconversion). 1. Health education and systematic surveillance. 2. Routine premarital/prenatal serology. 3. VDRL at first visit for suspected pregnant women; treat and consider abortion if confirmed. 4. Follow high-risk neonates.

Department to Visit

It is recommended to visit the General Pediatrics department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.