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What is Neonatal Syphilis?

Laura M. Sands
By Laura M. Sands
Updated May 17, 2024
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Neonatal syphilis refers to syphilis that is diagnosed in infants less than one month old. Commonly, this condition occurs as the result of congenital syphilis or fetal syphilis, which means it was acquired during the child’s development in the womb. Neonatal syphilis is commonly passed to a child by an infected mother.

If a fetus survives infection while in the womb, which many do not, newborn infants inflicted with neonatal syphilis often perish soon after birth. In those who survive, the infection is primarily treated with penicillin. Symptoms of neonatal syphilis that commonly occur shortly after birth include fever, a lack of weight gain, irritability and a watery nasal discharge. Some children are also born with irreversible symptoms, such as a deformity that leaves the child without a nose bridge. Other symptoms of neonatal syphilis include a rash on the genitalia and anus, as well as a blistery rash on the palms of the hands, soles of the feet, mouth or face.

During pregnancy, most women receive blood testing to determine the presence of syphilis and other infectious diseases. When children are born with syphilis, therefore, it is generally known about and treated immediately. Occasionally, a child may survive neonatal syphilis without detection and carry the disease into an older infant stage or may be infected at a later stage of childhood. Symptoms that may be experienced later include bone and joint pain, abnormally shaped teeth, deafness, blindness, neurological disorders, and unusual patches of gray skin on the anus or vaginal areas.

Neonatal syphilis can affect infants born to every race, culture or socioeconomic demographic. In adults, syphilis is spread by unprotected sexual contact, which is how pregnant women are initially infected with the disease. In the United States, pregnant women are tested early in prenatal care for diseases such as HIV and syphilis before being tested again near the end of a pregnancy. When detected, treating the disease with antibiotics will often cure the infection within approximately 10 days. Syphilis may reoccur, however, and is very easily passed from mother to child during pregnancy and delivery.

Cases of neonatal syphilis tend to be higher in children born to mothers who do not receive prenatal care. Some of the dermatological symptoms of syphilis experienced by infected adults are sometimes assumed to be due to other conditions such as eczema or alopecia, and may not be suspected before giving birth. Without timely treatment, syphilis can eventually cause aneurysm, psychosis and dementia.

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