Congenital syphilis presenting with liver lesions

Area of Science:

• Pediatrics
• Infectious Diseases
• Syphilology

Background:

• Congenital syphilis is a global concern, but uncommon in regions with robust antenatal screening.
• In the UK, 2016 saw three reported cases in infants whose mothers initially tested negative for syphilis.
• Clinical vigilance is crucial for diagnosing congenital syphilis in symptomatic infants.

Observation:

• A seven-week-old infant presented with symptoms suggestive of congenital syphilis.
• Unusually, the infant exhibited discrete liver lesions.
• The infant's mother had initially tested seronegative for syphilis at booking.

Findings:

• The infant was diagnosed with congenital syphilis.
• Discrete liver lesions were a notable clinical finding in this case.
• Diagnosis required high clinical suspicion despite initial negative maternal screening.

Implications:

• This case underscores the importance of considering congenital syphilis even with initial negative maternal screening.
• Prompt diagnosis and treatment, such as with intravenous ceftriaxone, are vital for favorable outcomes.
• Raising clinical awareness may improve early detection and management of congenital syphilis, particularly in atypical presentations.