Syphilis In Babies: Signs, Symptoms, Diagnosis And Treatment

Prompt treatment is crucial to preventing complications of this contagious infection.

Medically reviewed by Dr. Elna Gibson, MBChB, MMed Dr. Elna Gibson Dr. Elna GibsonMBChB, MMed facebook_icon Specialty: PediatricsExperience: 25 years
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Syphilis is a sexually transmitted infection or disease caused by the Treponema pallidum bacterium (1). An unborn baby can contract this infection from their mother during pregnancy or vaginal birth if the mother isn’t treated or treated inadequately for an active infection.

Syphilis in babies, also known as congenital syphilis, is treatable with timely diagnosis and prompt treatment. Leaving the condition untreated may result in adverse effects, such as severe anemia, meningitis, and bone damage. The infection is preventable if the mother takes adequate precautions to avoid the infection during pregnancy.

This post discusses the symptoms, diagnosis, treatment, and prevention of congenital syphilis.

Signs And Symptoms Of Syphilis In Babies

A baby with syphilis infection can show symptoms as early as three to fourteen weeks (early congenital syphilis) or as late as five years (late congenital syphilis). In some cases, late congenital syphilis symptoms may not appear until adulthood (2) (3).

Early congenital syphilis symptoms

  • Inflammation of the umbilical cord
  • Low birth weight
  • Skin irritation and cracking around the mouth and genitals
  • Skin rashes starting as blisters, especially on the palms and soles
  • Inflammation of the nasal mucous membrane (rhinitis) with watery nasal discharge
  • Fever
  • Enlarged liver or spleen or both
  • Meningitis
  • Jaundice
  • Severe anemia
  • Bone abnormalities

Late congenital syphilis symptoms

  • Clouding of the eyeball (cornea)
  • Gray, mucus-like patches around the anus and vagina
  • Abnormal, peg-shaped teeth (Hutchinson’s teeth)
  • Nose deformity with a flattened nasal bridge (saddle nose)
  • Painful, swollen joints, especially in the lower limbs
  • Nerve problems causing vision changes and blindness
  • Hearing problems or deafness

The severity of these symptoms varies from one baby to another. These symptoms may also occur in other conditions, so consult a doctor for an exact diagnosis.

Diagnosis Of Syphilis In Babies

The doctor will perform the following checks to diagnose congenital syphilis (3) (4).

  1. Physical examination: The doctor will examine the rashes, sores, or uneven patches. The doctors will look for eye inflammation, vision problems, deformities of the teeth, and deafness to confirm late congenital syphilis.
  1. Blood tests: A blood test can detect specific antibodies for the syphilis bacteria. In most cases, no further testing may be required. However, if the infection is severe, the doctor may perform a lumbar puncture to determine the extent of the infection.
  1. Lumbar puncture: Spinal tap or lumbar puncture is the procedure in which a doctor extracts a small quantity of cerebrospinal fluid from the spinal cord. This fluid is then tested for any infection, such as meningitis, that can occur due to syphilis.
  1. Xrays and ultrasound imaging: X-rays help locate and evaluate bone changes or deformities caused by syphilis. Ultrasound imaging is used to check the effect on organs, such as enlarged liver and spleen.

If the mother were tested positive for syphilis during pregnancy, the doctor would examine and test the placenta and umbilical cord for the bacteria’s presence. The above-mentioned diagnostic steps may be conducted on the newborn even if they are asymptomatic to rule out the spread of infection from the mother to the baby.

Experts recommend that siblings of an infant with confirmed syphilis infection must also undergo testing for syphilis.

Treatment For Congenital Syphilis

The antibiotic penicillin is the first-line treatment for syphilis infection in babies. The baby may receive penicillin through an injection or intravenous therapy. If the baby is suspected of having a penicillin allergy, the doctor may recommend another antibiotic or penicillin desensitization.

If the baby has additional health conditions due to syphilis, such as organ inflammation, parallel treatment will help manage or treat the conditions. The doctor will periodically evaluate the infant to check the response to the treatment.

The treatment must be prompt to avert lasting complications, such as blindness, deafness, facial deformity, and severe neurocognitive problems that affect the baby’s growth and development.

Tips To Prevent Syphilis In Babies

A mother can protect herself and her baby from the infection by following some precautionary steps.

  • Follow safe sexual practices, such as avoiding unprotected sexual activity, especially if you are not in a mutually monogamous relationship. Using barriers, such as male and female condoms, can significantly reduce the risk of transmission. Do note it may not prevent spread through syphilis sores present on other parts of the body.
  • Diligently follow your prenatal checkups, even if you don’t have any health issues. At prenatal checks, the doctor discusses the risk factors for syphilis and other infections. If you show symptoms, further tests and treatment could be conducted.
  • Prevent reinfection by staying alert to your partner’s syphilis risk. If you feel your partner might have syphilis, encourage them to get tested and treated promptly. If your partner tests positive, avoid sexual contact until they are cured.

Frequently Asked Questions

1. Can a baby get syphilis from kissing?

Yes, babies may get syphilis from close contacts, such as kissing a person carrying the active infection (5).

2. How many babies are affected by syphilis?

The World Health Organization reports that about 6 million new cases of congenital syphilis occur every year. In 2016, WHO estimated 6,61,000 cases of congenital syphilis worldwide (6).

3. Are all newborns tested for syphilis?

No, all newborns are not tested for syphilis. All neonates born to mothers who have tested positive for syphilis during pregnancy are tested for the presence of the infection. If the mother has a history of syphilis but an inadequate record of treatment, her newborn may be tested (7).

Syphilis is a sexually transmitted disease that is highly contagious but has a good recovery rate too. Babies can contract it from infected mothers during pregnancy or childbirth. When left untreated, it can cause severe complications. However, timely diagnosis and prompt treatment can help in faster resolution. The doctor may do a physical examination, blood tests, lumbar puncture, and other imaging tests to confirm the diagnosis and the severity of the infection. Further, maternal safe sex practices and regular prenatal checkups can help prevent syphilis in babies.

Key Pointers

  • Syphilis in babies is a treatable disease if diagnosed early on.
  • Meningitis, bone abnormalities, and skin rashes are common symptoms of early syphilis.
  • Blood tests and lumbar puncture help in the diagnosis of this condition.
  • Following safe sexual practices, attending prenatal check-ups, and other preventative measures are discussed below.


1. Syphilis – CDC Fact Sheet; CDC
2. Congenital Syphilis; National Organization For Rare Disorders
3. Congenital syphilis; Medline Plus
4. Congenital Syphilis; March Of Dimes
5. Fu-Quan Long et al,; Acquired Secondary Syphilis in Preschool Children by Nonsexual Close Contact; Journal of the American Sexually Transmitted Diseases Association
6. Mother-to-child transmission of syphilis; WHO
7. Congenital Syphilis; CDC
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Dr. Elna Gibson
Dr. Elna GibsonMBChB, MMed, Paeds
Dr. Elna Gibson is a general pediatrician. She did her MBChB and specialization as a pediatrician in South Africa at the University of Pretoria. She obtained MMed Pediatrics (masters) with distinction in 1993.As a young specialist, Dr.

Read full bio of Dr. Elna Gibson
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