Pediatric syphilis

What is pediatric syphilis?

Most pediatric cases of syphilis happen when a pregnant woman with syphilis spreads the disease to her fetus through the placenta or to her baby during childbirth. Syphilis is a sexually transmitted infection (STI), so a child can also contract the condition if they are sexually active or sexually abused.

A child who is infected with syphilis through sexual contact may not show any symptoms for about three weeks after infection. If caught right away, syphilis can be treated successfully. However, the outcome is more severe in babies with congenital (present at birth) syphilis. They may experience disabling and even life-threatening symptoms.

What are the different stages of pediatric syphilis?

The stages progress in order from the first stage until the last (i.e. a person will not have stage four, if they haven’t already had stages one through three).

• Primary stage - During this first (active) stage, a single or several sores will appear at the infection location and usually last about three to six weeks.

• Secondary stage - During this second (active) stage, rashes and other symptoms will appear. This stage can last one to six months.

• Latent stage - During this stage, the infection is not active and there are no visible symptoms. This stage typically lasts less than two years.

• Tertiary stage - During this third (active) stage, the infection can impact organs, including the brain, nervous system, heart and blood vessels. This stage is extremely dangerous and can occur 10 to 30 years after the initial infection.

• Neurosyphilis and ocular syphilis - This is the final stage and can impact the brain and nervous system or the eyes (ocular). This stage can occur any time after the tertiary stage, typically 10 years or more after the initial infection.

What are the signs and symptoms of pediatric syphilis?

Symptoms of syphilis vary and continue to develop and become worse as the stages progress.

Primary stage - The main symptom during this stage is one or multiple sores at the site of the infection. They will typically be hard, round and painless.

Secondary stage - During this stage, a rash usually starts in the anus, mouth or vagina. The rash can have red or red-brown spots, usually doesn’t itch and can also form on the palms of the hands or bottom of the feet.

• Fatigue (tiredness)

• Fever

• Hair loss (typically in patches)

• Headaches

• Muscle pain

• Sore throat

• Swollen lymph glands

• Weight loss

Tertiary stage

• Heart and blood vessel damage

• Nervous system damage

• Organ damage

Neurosyphilis and ocular syphilis

• Dementia

• Headaches (severe or migraine)

• Muscle movement or coordination issues

• Numbness or paralysis

• Vision changes or blindness

Symptoms passed to newborns may show immediate signs, or they may develop after several weeks, including:

• Anemia

• Bone infection

• Cataracts

• Deafness

• Fever

• Fluid retention

• Jaundice

• Rash

• Seizures

• Skin ulcers

• Swollen liver

• Swollen spleen

Symptoms from sexual abuse

• Aching joints

• Genital sores

• Headaches

• Mild fever

• Rash on palms of hands and soles of feet

• Skin sores

• Sores in the mouth and anus

• Sore throat

• Swollen lymph nodes

What are the causes of pediatric syphilis?

Syphilis is an infection caused by the bacteria Treponema pallidum that is found in the mouth, throat, rectum and vagina. If you are pregnant and have syphilis, your baby is at risk for having syphilis.

Risk factors

• Having a cut – The disease enters the blood stream through an opening in the skin (like a cut).

• Having a mother with syphilis – It is possible for a mother to infect her child in the womb or during vaginal childbirth.

• Being sexually active – Those that are sexually active have a greater risk of contracting syphilis. Further, the more sexual partners you have, the more likely you are to get syphilis. Being with a partner that has had multiple partners also increases your risk.

• Weakened immune system – Immune systems can be weakened by HIV/AIDS, immune-suppressing medications (organ transplants) or other reasons.