User:Mr. Ibrahem/Congenital syphilis

Congenital syphilis is syphilis that occurs when a mother with untreated syphilis passes the infection to her baby during pregnancy. It may be detected in the unborn baby as poor growth, excessive fluid leading to premature birth, or loss of the baby; though some have no signs. Features vary widely and may be divided into whether they present before or after age 2-years. Typically there are no signs in the first few weeks of life; though babies may be small and irritable. Features may include fever, rash, large liver and spleen, runny nose, or bone or joint pain. There may be yellowish skin and eyes, large glands, pneumonia, meningitis, warty bumps on genitals, deafness, or blindness. Untreated babies that survive may develop deformities of the nose, lower legs, forehead, collar bone, jaw, or cheek bone. There may be a perforated or high arched palate, joint disease, and intellectual disability. Seizures and cranial nerve palsies may occur in both early and late phases.

It is caused by the bacterium Treponema pallidum subspecies pallidum when it infects the baby after crossing the placenta during pregnancy or from contact with a syphilitic sore at birth. It is not transmitted during breastfeeding unless there is a syphilitic sore on the mother's breast. Most cases occur due to inadequate screening and treatment during pregnancy. The baby is highly infectious if the rash and snuffles are present. The disease may be suspected from tests on the mother; blood tests and ultrasound. Tests on the baby may include blood, CSF, and medical imaging. Findings may reveal low red blood, low platelets, low sugars, protein in the urine, or low thyroid. The placenta may appear large and pale. Other investigations include testing for HIV.

Prevention is by safe sex to prevent syphilis in the mother, and early screening and treatment in pregnancy. One intramuscular injection of benzathine penicillin G given to a pregnant woman early in the illness can prevent congenital syphilis in her baby. Treatment of suspected congenital syphilis is with penicillin by injection; benzylpenicillin, procaine benzylpenicillin, or benzathine penicillin G. During times of penicillin unavailability, ceftriaxone may be used. If there is a penicillin allergy, desensitisation may be an option.

Syphilis affects around a million pregnancies a year. In 2016, there were around 473 cases of congenital syphilis per 100,000 live births and 204,000 deaths from the disease worldwide. Of 660,000 cases reported in 2016, 143,000 resulted in deaths of unborn babies, 61,000 deaths of newborn babies, 41,000 low birth weights or preterm births, and 109,000 young children diagnosed with congenital syphilis. Around 75% were from the African and Eastern Mediterranean regions. The cost of preventing syphilis in the mother and baby and in treating the disease is generally inexpensive. The disease was first described in the sixteenth century. Blood tests for syphilis were introduced in 1906, and it was later shown that spread occurred from the mother.