CONGENITAL SYPHILIS

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Signs and symptoms

  • Often low birth weight
  • Palms and soles: red rash, grey patches, blisters, or skin peeling
  • ‘Snuffles’: highly infectious rhinitis with nasal obstruction
  • Abdominal distension due to enlarged liver and spleen
  • Jaundice
  • Anaemia

Some very-low-birth-weight infants with syphilis have signs of severe sepsis with lethargy, respiratory distress, skin petechiae, or other bleeding.

Investigation

If you suspect syphilis, do a VDRL test if possible

Non-pharmacological and pharmacological treatment

Asymptomatic neonates born to women with a positive VDRL or rapid plasma reagin test should receive:

Benzathine benzylpenicillin IM

37.5 mg/kg (50 000 U/kg) IM in a single dose

 

Symptomatic infants should be treated with:

Procaine benzylpenicillin deep IM injection daily for 10 days

50 mg/kg as a single dose

OR

Benzylpenicillin at 30 mg/kg every 12 h IV for the first 7 days of life and then 30 mg/kg every 8 h for a further 3 days.

  • Treat the mother and her partner for syphilis and check for other sexually transmitted infections.