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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Definitions
- Congenital syphilis (CS): Transmission of Treponema pallidum to fetus from infected mother
- Early-onset CS: Clinically manifests < 2 years of age
- Late-onset CS: Clinically manifests > 2 years of age
- "Great imitator" (coined by Sir William Osler)
- Acquired syphilis
- Occurrence of syphilis via sexual transmission
- May see in sexually abused children
- Primary syphilis: Chancre at site of inoculation
- Secondary syphilis: Systemic disease develops weeks to months after infection
- Latent syphilis: Asymptomatic period with positive serologic tests
- Tertiary syphilis: Development of late complications (e.g., CNS, cardiovascular, bones, & skin)
- Osseous findings in acquired syphilis typically occur in tertiary syphilis
- Occurrence of syphilis via sexual transmission
- Congenital syphilis (CS): Transmission of Treponema pallidum to fetus from infected mother
IMAGING
General Features
Radiographic Findings
Ultrasonographic Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
Laboratory Tests
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Kimball A et al: Congenital syphilis diagnosed beyond the neonatal period in the United States: 2014-2018. Pediatrics. 148(3), 2021
- Medoro AK et al: Syphilis in neonates and infants. Clin Perinatol. 48(2):293-309, 2021
- Moodley A et al: The term newborn: congenital infections. Clin Perinatol. 48(3):485-511, 2021
- Jacobs K et al: Congenital syphilis misdiagnosed as suspected nonaccidental trauma. Pediatrics. 144(4), 2019
- Kan JH et al: Musculoskeletal infections. Caffey's pediatric diagnostic imaging. 13th ed. Elsevier. 1349-64, 2019
- Cooper JM et al: Congenital syphilis. Semin Perinatol. 42(3):176-84, 2018
- Moline HR et al: The continuing threat of syphilis in pregnancy. Curr Opin Obstet Gynecol. 28(2):101-4, 2016
- Bowen V et al: Increase in incidence of congenital syphilis - United States, 2012-2014. MMWR Morb Mortal Wkly Rep. 64(44):1241-5, 2015
- Rac MW et al: Progression of ultrasound findings of fetal syphilis after maternal treatment. Am J Obstet Gynecol. 211(4):426.e1-6, 2014
- Araujo Júnior E et al: Prenatal diagnosis of congenital syphilis using two- and three-dimensional ultrasonography: case report. Case Rep Infect Dis. 2012:478436, 2012
- Miller R et al: Commentary. Update on emerging infections: news from the Centers for Disease Control and Prevention. Congenital syphilis--United States 2003-2008. Ann Emerg Med. 56(3):296-7, 2010
- Bell C et al: Pulmonary abscesses in congenital syphilis. Arch Pathol Lab Med. 126(4):484-6, 2002
- Nolt D et al: Survival with hypopituitarism from congenital syphilis. Pediatrics. 109(4):e63, 2002
- Coimbra AV et al: Weismann-Netter-Stuhl syndrome: first Brazilian case reports. Joint Bone Spine. 67(6):539-43, 2000
- Ajayi NA et al: Intestinal ulceration, obstruction, and haemorrhage in congenital syphilis. Pediatr Surg Int. 15(5-6):391-3, 1999
- Christian CW et al: Preschoolers with syphilis. Pediatrics. 103(1):E4, 1999
- Moyer VA et al: Contribution of long-bone radiographs to the management of congenital syphilis in the newborn infant. Arch Pediatr Adolesc Med. 152(4):353-7, 1998
- Ghadouane M et al: Skeletal lesions in early congenital syphilis (a review of 86 cases). Rev Rhum Engl Ed. 62(6):433-7, 1995
- Herman TE: Extensive hepatic calcification secondary to fulminant neonatal syphilitic hepatitis. Pediatr Radiol. 25(2):120-2, 1995
- Starling SP: Syphilis in infants and young children. Pediatr Ann. 23(7):334-40, 1994
- Rasool MN et al: The skeletal manifestations of congenital syphilis. A review of 197 cases. J Bone Joint Surg Br. 71(5):752-5, 1989
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References
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Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Definitions
- Congenital syphilis (CS): Transmission of Treponema pallidum to fetus from infected mother
- Early-onset CS: Clinically manifests < 2 years of age
- Late-onset CS: Clinically manifests > 2 years of age
- "Great imitator" (coined by Sir William Osler)
- Acquired syphilis
- Occurrence of syphilis via sexual transmission
- May see in sexually abused children
- Primary syphilis: Chancre at site of inoculation
- Secondary syphilis: Systemic disease develops weeks to months after infection
- Latent syphilis: Asymptomatic period with positive serologic tests
- Tertiary syphilis: Development of late complications (e.g., CNS, cardiovascular, bones, & skin)
- Osseous findings in acquired syphilis typically occur in tertiary syphilis
- Occurrence of syphilis via sexual transmission
- Congenital syphilis (CS): Transmission of Treponema pallidum to fetus from infected mother
IMAGING
General Features
Radiographic Findings
Ultrasonographic Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
Laboratory Tests
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Kimball A et al: Congenital syphilis diagnosed beyond the neonatal period in the United States: 2014-2018. Pediatrics. 148(3), 2021
- Medoro AK et al: Syphilis in neonates and infants. Clin Perinatol. 48(2):293-309, 2021
- Moodley A et al: The term newborn: congenital infections. Clin Perinatol. 48(3):485-511, 2021
- Jacobs K et al: Congenital syphilis misdiagnosed as suspected nonaccidental trauma. Pediatrics. 144(4), 2019
- Kan JH et al: Musculoskeletal infections. Caffey's pediatric diagnostic imaging. 13th ed. Elsevier. 1349-64, 2019
- Cooper JM et al: Congenital syphilis. Semin Perinatol. 42(3):176-84, 2018
- Moline HR et al: The continuing threat of syphilis in pregnancy. Curr Opin Obstet Gynecol. 28(2):101-4, 2016
- Bowen V et al: Increase in incidence of congenital syphilis - United States, 2012-2014. MMWR Morb Mortal Wkly Rep. 64(44):1241-5, 2015
- Rac MW et al: Progression of ultrasound findings of fetal syphilis after maternal treatment. Am J Obstet Gynecol. 211(4):426.e1-6, 2014
- Araujo Júnior E et al: Prenatal diagnosis of congenital syphilis using two- and three-dimensional ultrasonography: case report. Case Rep Infect Dis. 2012:478436, 2012
- Miller R et al: Commentary. Update on emerging infections: news from the Centers for Disease Control and Prevention. Congenital syphilis--United States 2003-2008. Ann Emerg Med. 56(3):296-7, 2010
- Bell C et al: Pulmonary abscesses in congenital syphilis. Arch Pathol Lab Med. 126(4):484-6, 2002
- Nolt D et al: Survival with hypopituitarism from congenital syphilis. Pediatrics. 109(4):e63, 2002
- Coimbra AV et al: Weismann-Netter-Stuhl syndrome: first Brazilian case reports. Joint Bone Spine. 67(6):539-43, 2000
- Ajayi NA et al: Intestinal ulceration, obstruction, and haemorrhage in congenital syphilis. Pediatr Surg Int. 15(5-6):391-3, 1999
- Christian CW et al: Preschoolers with syphilis. Pediatrics. 103(1):E4, 1999
- Moyer VA et al: Contribution of long-bone radiographs to the management of congenital syphilis in the newborn infant. Arch Pediatr Adolesc Med. 152(4):353-7, 1998
- Ghadouane M et al: Skeletal lesions in early congenital syphilis (a review of 86 cases). Rev Rhum Engl Ed. 62(6):433-7, 1995
- Herman TE: Extensive hepatic calcification secondary to fulminant neonatal syphilitic hepatitis. Pediatr Radiol. 25(2):120-2, 1995
- Starling SP: Syphilis in infants and young children. Pediatr Ann. 23(7):334-40, 1994
- Rasool MN et al: The skeletal manifestations of congenital syphilis. A review of 197 cases. J Bone Joint Surg Br. 71(5):752-5, 1989
