In utero syphilis infection

Last revised by Leonardo Lustosa on 31 Mar 2022

In utero syphilis infection, or congenital syphilis, results from transplacental transmission of the maternal infection from the spirochete Treponema pallidum, subspecies pallidum

For a general discussion, and for links to other system specific manifestations, please refer to the article on syphilis

The pathogen is capable of crossing the placenta during any time in gestation. 

The following tests can be assessed on maternal blood

  • fluorescent treponemal antibody absorbed test (FTA-ABS)
  • rapid plasma reagin (RPR)
  • venereal disease research laboratory test (VDRL)

Sonographic features are often non specific and mimic those of the generalized in utero infection

Such features include

In severe cases there may be evidence of 

Treatment in often with penicillin. Fetal demise or still birth can occur in ~ 50% of untreated cases. Fetus developing hydrops tend to have a very poor prognosis.

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Cases and figures

  • Case 1: Congenital syphilis
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  • Case 2: Late congenital syphilis
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  • Case 3: Wimberger sign of congenital syphilis
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