A clinical case of early congenital syphilis

Congenital syphilis results from vertical transmission of Treponema pallidum to the fetus from an infected mother who was not treated before 32 weeks of gestation. Thanks to the development of obstetric and gynecological services, incidence rates of congenital syphilis are decreasing annually, even against the background of an increase in cases of acquired syphilis among the adult population. Depending on the time of manifestation, early (onset before 2 years) and late (onset after 2 years) congenital syphilis are distinguished. The clinical picture of both congenital and acquired syphilis has wide variability and requires careful differential diagnosis with other diseases of infectious and non-infectious nature. The relatively rare frequency of occurrence and the polymorphism of clinical manifestations reduce the alertness of clinicians regarding this disease. Diagnosis is not difficult provided that a correct history is taken and direct (identification of the pathogen itself) and indirect (serological reactions) laboratory tests are carried out. However, the erased course with a small number of clinical manifestations may delay the early detection of the disease. Syphilitic infection in both mother and child is traditionally treated with beta-lactam antibiotics. The prognosis for life and health is individual in each case and depends on concomitant conditions. This article presents a clinical case of early congenital syphilis in a child whose mother was not observed in the antenatal clinic during pregnancy and was infected with Treponema pallidum in the II—III trimesters. Attention is focused on the importance of a thorough history taking even in the presence of non-specific symptoms.