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By ULY CLINIC staff

 

Congenital syphilis

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Introduction

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This is a multisystem infection caused by Treponema pallidum and transmitted to
the fetus via the placenta. In infected neonates, manifestations of syphilis are classified as early congenital (birth through age 2 year) and late congenital (after age 2 year). Early signs are characteristic skin lesions, lymphadenopathy, hepatosplenomegaly, failure to thrive, blood-stained nasal discharge, microcephaly, jaundice, petechiae, periventricular calcifications, chorioretinitis, pneumonitis, hepatitis and hearing loss

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Diagnostic Criteria

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  • Anaemia, Jaundice, low birth weight

  • Red rush, grey patches, blisters or skin peeling of palms and soles

  • Snuffles

  • Abdominal distension due to hepatosplenomegaly

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One or more of the above clinical features and positive VDRL (venereal disease research laboratory) or RPR (rapid plasma reagin test)
 

Investigations

 

  • VDRL

  • RPR


Treatment


Pharmacological Treatment

 

Asymptomatic neonates with positive VDRL

 

  • Give Benzyl penicillin IM 7.5 mg/kg of single dose

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Symptomatic infants

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  • Benzylpenicillin IV 50,000IU (30mg/kg) 12 hourly for the 1st 7days of life, then 50,000IU (30mg/kg) 8 hourly for 3 days.

  • Treat the mother and the partner.•

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Note:


Infant of a Mother with Tuberculosis


If the mother has active PTB and was treated for <2months before birth.

  • Reassure the mother that it is safe for her to breastfeed her infant

  • Do not give BCG at birth

  • Give prophylactic Isoniazid at 10mg/kg by mouth once daily for 6 months

  • Re-evaluate every 4 weeks

 

If finding suggest active TB disease in a newborn

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  • Start anti TB treatment according to National guideline.

  • Give BCG vaccination two weeks after treatment is completed


If no findings suggestive of an active TB disease in a newborn

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  • Give prophylactic Isoniazid PO 10mg/kg by mouth once daily for 6 months

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Last updated on 23.08.2020

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References

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