Varied presentations of early congenital syphilis

In spite of availability of cost-effective preventive measures and treatment, a resurgence of congenital syphilis has currently been noted. During the past 4 years, we came across five low birth weight neonates with unusual symptoms, which subsequently proved to be manifestations of early congenital syphilis. All the mothers had apparently uneventful antenatal period. No investigation was done during pregnancy. They were unaware about their disease and were found to be positive for syphilis by Venereal Disease Research Laboratory Test and fluorescent treponemal antibody (absorbed) IgM test only after childbirth. Screening for other congenital infections was negative. All the neonates were positive for Venereal Disease Research Laboratory Test. They were treated with intravenous crystalline penicillin G for 10 days. Recovery was uneventful. We reemphasize the importance of raising public awareness, routine antenatal screening and treatment for all pregnant mothers to avoid such a potentially treatable condition.