A forgotten foe: Congenital syphilis in the modern era

Congenital syphilis, caused by the spirochete Treponema pallidum, is transmitted transplacentally or through direct contact with maternal lesions during delivery. It is classified as early congenital syphilis when symptoms appear within the first 2 years of life, and late when they manifest after 2 years, indicating long-term or delayed complications. We report a case of early congenital syphilis in a preterm neonate, confirmed by venereal disease research laboratory titers more than four times higher than maternal levels and a positive fluorescent treponemal antibody absorption test, presenting with respiratory distress, thrombocytopenia, hepatobiliary dysfunction, and skeletal abnormalities.