Clinical presentation of children with suspected congenital syphilis in pediatric hospital in the South of Brazil

Congenital syphilis is a relevant infection with potentially serious outcomes. This research aims to describe the clinical presentation, investigation and treatment of suspected cases of congenital syphilis. This is an observational, retrospective and descriptive study with a sample of patients with suspected congenital syphilis, treated at the pediatric infectious diseases clinic of a public childrens hospital in Florianópolis, Santa Catarina, Brazil, in 2021 and 2022, with data collection via medical records, tabulation and analysis. It was approved by the institutional Research Ethics Committee, with no financial support or conflicts of interest. A total of 142 cases were analyzed. The diagnosis in 82 (97.62%) of the cases of congenital syphilis was made in the neonatal period, with 34 (23.94%) of the confirmed cases being asymptomatic at birth. The most common signs and symptoms at birth were jaundice and respiratory distress. At consultations, anemia, skin lesions and delayed neuropsychomotor development were most observed, with 56 (66.27%) of congenital syphilis cases asymptomatic. Regarding the investigation, non-treponemal tests were reactive in 132 (92.95%) cases, altered long bone radiographs were found in 10 (7.04%) and altered cerebrospinal fluid in 25 (17.61%). Neonatal treatment was performed in 78 (92.86%) of the cases of congenital syphilis. Congenital syphilis infection has a highly nonspecific clinical presentation, leading to diagnostic difficulties and potential treatment delay. The importance of investigation with cerebrospinal fluid testing and long bone radiographs is reinforced, as well as longitudinal monitoring, to observe symptoms, define conduct and timely treatment.