Congenital Syphilis: A Threat to Neonatal Health

Syphilis is primarily a sexually transmitted infection caused by the bacteria Treponema pallidum Cases of syphilis have surged in the United States, with an estimated increase of 80% between 2018 and 2022. Likewise, cases of congenital syphilis (CS) have increased by 740% over the past decade. Congenital syphilis is the second leading cause of stillbirth worldwide and is associated with a mortality risk of nearly 40%. Among fetuses who acquire CS and survive, complications include growth restriction, hydrops fetalis, premature birth, permanent sensorineural hearing loss, facial and dental defects, ocular abnormalities, musculoskeletal deformities, and impaired neurodevelopment in childhood. Consistent educational outreach, increased access to prenatal care and testing, and treatment with benzathine penicillin G are essential to reduce the spread of syphilis in communities and protect the developing fetus. In this article, we present a case report of a preterm neonate with CS and a discussion of the state of the science of syphilis infection.