See also general section on "Syphilis"

I. Congenital syphilis:

  1. Results from maternal spirochetemia during pregnancy
  2. Can cause stillbirth, nonimmune fetal hydrops, IUGR, & preterm labor.
  3. Suspect anytime you see large placenta, unexplained hydrops, rash, or rhinitis.
  4. Late congenital syphilis: >2yo; presents with dental abnormalities, saddle nose, pick-shaped permanent incisors, keratosis of eye.

II. Treatment of pregnant women: PCN G; if using erythromycin, need to treat baby after delivery because it crosses placenta poorly

  1. For primary, secondary, or early latent (< 1y), Benzathine Penicillin G 2.4million U IM
  2. For late latent syphilis (duration uncertain or > 1y), 2.4million U IM Qwk x 3wks