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 Congenital syphilis occurs most
frequently during maternal primary or
secondary syphilis, when the
spirochetes are most numerous.
 Intrauterine death and perinatal death
occurs in approx 25% of cases of
untreated congenital syphilis.
 Manifestations of congenital syphilis are
divided into two: infantile an tardive.
 Infantile – occur in the first two years of life.
 Tardive- occur later.
 Infantile syphilis is often manifested by nasal
discharge and congestion.
 A desquamating or bullous rash can lead to
sloughing of skin of the hands and feet and
around mouth and anus.
 Hepatomegaly and skeletal abnormalities are
common.
 Late or tardive syphilis develop in nearly half
of untreated children with neonatal syphilis.
 The rash of congenital syphilis is more severe
than that of adult secondary syphilis.
 It is a bullous eruption of the palm and soles
associated with epidermal sloughing.
 Syphilitic osteochondritis and periostitis
affect all bones, but lesions of nose and lower
leg are most distinctive.
 Destruction of the vomer causes collapse of
the bridge of the nose and, later on, the
saddle nose deformity.
 Periostitis of tibia leads to excessive new
bone growth on anterior surfaces and
anterior bowing or saber shin.
 The epiphysis become widened as the
cartilage grows, and cartilage is found in
displaced islands within the metaphysis.
 The liver is often severely affected in
congenital syphilis.
 Diffuse fibrosis permeates lbules to isolate
hepatic cells into small nests, accompanied
by the lymphoblastic infiltrate and vascular
changes.
 Gummas are occasionally found in liver ,even
in early cases.
 In the syphilitic stillborn the lungs appear
pale and airless called pneumonia alba.
 The generalized spirochetemia may lead to
diffuse interstitial inflammatory reactions in
virtually any other organ.
 The late manifestations include a triad of
interstitial keratitis, hutchinson teeth, and
eighth nerve deafness.
 Ocular changes also include choroiditis and
abnormal retinal pigmentation.
 Hutchinson teeth are small incisors shaped
like a screwdriver or a peg, often with
notches in the enamel.
 Eighth nerve deafness and optic nerve
atrophy develop secondary to
meningiovascular syphilis.
 YAWS – Tryponema pallidum pertenue
 PINTA – Tryponema pallidum carateum.

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Congenital Syphilis

  • 1.
  • 2.  Congenital syphilis occurs most frequently during maternal primary or secondary syphilis, when the spirochetes are most numerous.  Intrauterine death and perinatal death occurs in approx 25% of cases of untreated congenital syphilis.
  • 3.  Manifestations of congenital syphilis are divided into two: infantile an tardive.  Infantile – occur in the first two years of life.  Tardive- occur later.
  • 4.  Infantile syphilis is often manifested by nasal discharge and congestion.  A desquamating or bullous rash can lead to sloughing of skin of the hands and feet and around mouth and anus.  Hepatomegaly and skeletal abnormalities are common.
  • 5.  Late or tardive syphilis develop in nearly half of untreated children with neonatal syphilis.
  • 6.  The rash of congenital syphilis is more severe than that of adult secondary syphilis.  It is a bullous eruption of the palm and soles associated with epidermal sloughing.
  • 7.  Syphilitic osteochondritis and periostitis affect all bones, but lesions of nose and lower leg are most distinctive.  Destruction of the vomer causes collapse of the bridge of the nose and, later on, the saddle nose deformity.
  • 8.  Periostitis of tibia leads to excessive new bone growth on anterior surfaces and anterior bowing or saber shin.  The epiphysis become widened as the cartilage grows, and cartilage is found in displaced islands within the metaphysis.
  • 9.  The liver is often severely affected in congenital syphilis.  Diffuse fibrosis permeates lbules to isolate hepatic cells into small nests, accompanied by the lymphoblastic infiltrate and vascular changes.  Gummas are occasionally found in liver ,even in early cases.
  • 10.  In the syphilitic stillborn the lungs appear pale and airless called pneumonia alba.  The generalized spirochetemia may lead to diffuse interstitial inflammatory reactions in virtually any other organ.
  • 11.  The late manifestations include a triad of interstitial keratitis, hutchinson teeth, and eighth nerve deafness.  Ocular changes also include choroiditis and abnormal retinal pigmentation.
  • 12.  Hutchinson teeth are small incisors shaped like a screwdriver or a peg, often with notches in the enamel.  Eighth nerve deafness and optic nerve atrophy develop secondary to meningiovascular syphilis.
  • 13.  YAWS – Tryponema pallidum pertenue  PINTA – Tryponema pallidum carateum.