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May 1969

Congenital Syphilis

Author Affiliations


Formerly Physician-in-Charge, Family Syphilis Clinic, Medicine I Division of the Medical Clinic, John Hopkins Hospital, Baltimore, under the direction of the late Dr. Joseph Earle Moore.

Arch Dermatol. 1969;99(5):599-610. doi:10.1001/archderm.1969.01610230091019

The increase in incidence of infectious syphilis has created the problem of the probability of intrauterine infection in undetected disease. Newer serologic tests utilizing treponemal immobilization or FTA absorption are more sensitive than reagin-detecting tests, but may be confusing. Diagnosis must depend on recognition and evaluation of clinical signs, as well as laboratory phenomena.

Previous studies have established the limit of maternal reagin carryover at 70 days. In this study, it has been shown that the infant may retain maternal reagin at least 100 days. When infant's blood is unobtainable at birth, cord blood STS may be used as a baseline for future tests.

Transfer of maternal reagin to the infant is less frequent when syphilotherapy is accomplished in the first trimester than when given later in pregnancy. Treatment of maternal early syphilis in the latter half of pregnancy constitutes treatment of intrauterine congenital syphilis, not prevention.

Most of the stigmas described in the literature may occur in other conditions and are etiologically indistinguishable. Some are associated with vitamin deficiencies and some have no pathologic significance.

Only clinically characteristic interstitial keratitis, mulberry molars, and upper central incisors of the second dentition as described by Hutchinson may be classed as pathognomic.

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