Approach to Prevention, Diagnosis, and Treatment of Congenital Syphilis

Pediatr Clin North Am. 2025 Aug;72(4):685-699. doi: 10.1016/j.pcl.2025.03.007. Epub 2025 May 8.

Abstract

This article examines syphilis epidemiology in the U.S. and the pathogenesis of congenital syphilis. It also summarizes the clinical manifestations, diagnosis, and treatment of syphilis in pregnant individuals and infants at risk for congenital syphilis. Accurate diagnosis in asymptomatic infants requires understanding maternal risk factors, symptoms, and treatment history. Pediatric clinicians must recognize syphilis in pregnancy, communicate effectively with birthing parents and obstetric providers, and review relevant maternal records. Timely diagnosis and treatment of at-risk infants are essential for best outcomes.

Keywords: Congenital; Infant; Penicillin; Pregnancy; Sexually transmitted infection; Syphilis.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Female
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical* / prevention & control
  • Pregnancy
  • Pregnancy Complications, Infectious* / diagnosis
  • Pregnancy Complications, Infectious* / drug therapy
  • Pregnancy Complications, Infectious* / epidemiology
  • Pregnancy Complications, Infectious* / prevention & control
  • Risk Factors
  • Syphilis, Congenital* / diagnosis
  • Syphilis, Congenital* / drug therapy
  • Syphilis, Congenital* / epidemiology
  • Syphilis, Congenital* / prevention & control
  • Syphilis, Congenital* / therapy
  • United States / epidemiology

Substances

  • Anti-Bacterial Agents