Diagnosis and Treatment of Congenital Syphilis in a Baby

QUESTION: I am a bit too embarrassed to ask this question from our physician,
but circumstances make the answer very important to me. I would like to know
something about the signs of congenital syphilis in a baby. How may a
diagnosis be made, and is there any effective treatment available?
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ANSWER: Congenital syphilis is transmitted to the baby from the mother by way
of the placenta. The risk of this infection depends upon the stage of the
mother's infection. If the mother is in the early, untreated stage, the baby
almost invariably contracts the disease. However, if the mother is in the
latent or tertiary stage, the risk is much less. In early congenital syphilis
the baby fails to thrive, and may develop a characteristic "old man" look.
Skin lesions are common, a copper colored lesion is evident on the soles of
the feet and palms of the hand, while papular lesions are frequent around the
nose, mouth and diaper area. While many such patients remain in a latent
stage throughout life, others develop ulcers of nose, nasal septum and hard
palate. Bony changes may be seen on x-ray, and the nervous system may be
attacked, resulting in mental retardation and blindness should the optic nerve
become involved. Early stages of the disease in infants may be diagnosed by
finding the cause of the disease, Treponema pallidum, in scrapings from skin
or mucosal lesions. When the disease is diagnosed, both mother and child
should be treated with appropriate injections of penicillin in large doses.
The outlook is good for the baby if serious damage has not already occurred,
but continued watching must go on well into adult life.