Challenges in the diagnosis and treatment of congenital syphilis

Despite the advent of effective antibiotic treatment of Treponema pallidum, syphilis continues to be present in our population and recently has been increasing in frequency. The consequences can be especially dire in the setting of an untreated infection in pregnancy. This case report describes a case of congenital syphilis in a dichorionic-diamniotic twin pregnancy that resulted in a stillbirth of one twin and the characteristic findings of congenital syphilis in the surviving twin. This report demonstrates a number of challenges to the clinician in the effective and timely diagnosis and treatment of syphilis in pregnancy.