Congenital syphilis in a 4-month-old infant with limb weakness

Area of Science:

• Pediatric Infectious Diseases
• Neonatology
• Syphilology

Background:

• Congenital syphilis is a serious infection transmitted from mother to child during pregnancy or childbirth.
• The incidence of congenital syphilis is rising globally, necessitating increased clinical awareness.
• Early recognition and treatment are vital to prevent severe, long-term health consequences for affected infants.

Observation:

• A 4-month-old infant girl presented with several months of decreased left arm movement and a maculopapular rash on her limbs.
• Radiographic examination revealed inflammatory periosteal changes in the radius and ulna, indicative of bone involvement.
• Diagnostic tests confirmed the presence of Treponema pallidum IgM antibodies in both the infant and her mother.

Findings:

• The clinical presentation and serological results led to a diagnosis of congenital syphilis.
• The case highlights the diverse and sometimes subtle manifestations of congenital syphilis in infants.
• Differential diagnoses considered included non-accidental injury, malignancy, autoimmune disorders, and other congenital infections.

Implications:

• This case underscores the importance of considering congenital syphilis in the differential diagnosis of infantile limb abnormalities and rashes.
• Prompt diagnosis and appropriate treatment are essential to mitigate the risk of chronic, potentially life-threatening complications.
• Healthcare providers must remain vigilant for rising rates of congenital syphilis and ensure timely management to improve infant outcomes.