Congenital Syphilis in Darker Skin

00:01 Welcome to our lecture on congenital syphilis.

00:05 What is congenital syphilis? It is a severe, disabling and often life-threatening infection observed in infants born to mothers who were infected and not adequately treated whilst having syphilis. So congenital syphilis is due to an untreated mother with either primary or secondary syphilis.

00:31 Then there is vertical transmission, which can happen at any time during pregnancy.

00:38 It occurs in 90% of cases with an untreated mother.

00:43 Then you get infection of the fetus.

00:48 So let's see now what actually happens to the fetus that's been infected by syphilis from the mother.

00:57 The fetus has a high risk for spontaneous abortion or stillbirth if it is infected .

01:05 If the fetus survives, there is a high chance of congenital syphilis. So how do we classify congenital syphilis? Early congenital syphilis, that is, if clinical manifestations appear in the first two years of life and we call it late congenital syphilis.

01:25 If clinical manifestations appear after the age of two years.

01:29 So what are some of the clinical manifestations? In early congenital syphilis, 60 to 90% of the infants are asymptomatic at birth.

01:39 Symptoms develop within the first two months of life, and they may present with hepatomegaly, jaundice and skeletal abnormalities, rash, as well as generalized lymphadenopathy.

01:55 So we can also see swelling of knee joints and erosions in the distal end of the femur.

02:04 Now we're going to talk about late congenital syphilis.

02:09 So late congenital syphilis occurs as a sequelae of the scarring that occurs in the systemic infection, and that leads to the late manifestations of congenital syphilis.

02:25 And some of the presentations include Hutchinson's triad, and this includes interstitial keratitis, firstly, and Hutchinson's teeth.

02:37 Another feature of late congenital syphilis is a saddle nose.

02:42 Another feature is frontal bossing, as you can see on the picture, as well as saber shins, which is anterior bowing of the shins. You may also see clutton's joints, which is defined as painless arthritis in the knees.