Syphilis connata A50.9

Extremely rare infectious disease caused by intrauterine transmitted syphilis. The time of transmission, the stage of the mother's disease and the number of pathogens is crucial for the clinical picture in the child.

• Florid early syphilis in the mother: diaplacental transfer of the pathogen to the fruit (4th to 5th month of pregnancy): In the 7th to 8th month of pregnancy, syphilitic stillbirth occurs in 80-90% of cases.
• Florid late acquired syphilis of the mother: Living child with syphilis connata.
• Late syphilis of the mother: birth of a healthy child is possible. Infection of the child through the birth process is possible.

• Syphilis connata praecox: Syphilitic symptoms in newborns up to the age of 2 years. Atrophic, senile, poorly thriving children with withered, yellowish, flaccid skin, anemia and hepatosplenomegaly.
• Further possible are skin and mucous membrane changes of Syphilis acquisita II as well as polyscleradenitis syphilitica, high-singer infiltrates, parrot furrows, syphilitic shiny skin, pemphigus syphiliticus. Tooth anomalies (Hutchinson's teeth) affect the upper incisors which are barrel-shaped.
• Later, rhinitis syphilitica, pneumonia alba, interstitial hepatitis, osteochondritis syphilitica, parrot pseudoparalysis, hydrocephalus communicans hypersecretorius may also appear.

• Syphilis congenita precox: Benzylpenicillin (e.g. Penicillin Grünenthal) 2-3 times/day 50.000 IU/kg i.v. in 4-6 ED. Therapy duration: 14 days. With CNS involvement: benzathine benzylpenicillin (e.g. Tardocillin 1200) 3 doses at weekly intervals with 20,000 IU/kg bw i.v. each time. Alternatively ceftriaxone (Rocephin): infants > 2 weeks/children < 12 years.: once/day 20-100 mg/kg bw i.v.
• Syphilis congenita tarda: From the 2nd year of life onwards, treatment is the same as for acquired late syphilis in adults without CNS involvement, see below. Syphilis acquisita.

• Development of syphilis III, also syphilis IV, is possible after years.
• Syphilis connata tarda: Syphilitic symptoms in adolescents and adults after intrauterine transmission of syphilis are e.g. syphilitic saddle nose, Parrot furrows, Hutchinson's triad. In addition, bone abnormalities after osteochondritis syphilitica, hyperplastic osteochondritis and periostitis, caput natiforme, Olympic forehead, sabre vaginal form of the tibia, Higoumenakis sign, juvenile Tabes dorsalis and progressive paralysis may occur. S.a.u. Syphilis acquisita.