CONGENITAL-SYPHILIS - SUBTLE PRESENTATION OF FULMINANT DISEASE

The incidence of congenital syphilis has experienced a foul-fold to fi vefold increase in 6 years. It is a completely preventable disease who se clinical spectrum ranges from asymptomatic infection, to fulminant sepsis, to death. Congenital syphilis was diagnosed in a 6-week-old in fant whose mother was negative for the disease by prenatal screen. The otherwise well child presented with a generalized, papulosquamous eru ption of 3 weeks' duration but within hours multisystem failure develo ped from overwhelming treponemal sepsis. Factors related to increased incidence, problems in serodiagnosis, manifestations of the early vers us late forms of the disease, and recommendations for evaluation and t reatment are illustrated by this patient and are discussed.