Asymptomatic congenital syphilis and auditory brainstem response

Untreated congenital syphilis is a known cause of hearing loss. In order to ascertain if infants are at risk of hearing loss at birth, 75 neonates with serologic evidence of syphilis and APGAR scores greater than 9 at 5 min were examined by auditory brainstem response (ABR) audiometry. All of the infants had normal ABRs. Ophthalmologic examination revealed no evidence of interstitial keratitis. Lumbar puncture was attempted on all the neonates. Cerebrospinal fluid (CSF) was successfully obtained from 41 infants and revealed no abnormalities. This study demonstrates that asymptomatic infants with serologic evidence of syphilis do not require audiologic evaluation in the neonatal period.