Introduction: Congenital syphilis is a major public health problem, and early diagnosis and treatment are necessary to prevent it.Penicillin G benzathine is the treatment of choice in pregnant women; however, it may fail to prevent fetal infection, as in the present case.Case presentation: Male newborn, son of an HIV negative mother with gestational syphilis (venereal disease research laboratory click here (VDRL) 1:4 dilution, positive treponemal test) diagnosed at week 21 of gestation and treated with three doses of 2 400 000 IU of penicillin G benzathine.At delivery, the mother presented VDRL 1:1 dilution.
The newborn was diagnosed with congenital syphilis due to VDRL 1:4 dilution, positive treponemal test, elevated aspartate aminotransferases, hyposthenuria, proteinuria, hematuria, and leukocyturia that resolved after treatment with crystalline penicillin for 10 days.The molecular testing in blood showed a high treponemal load.The VDRL test at 3 months was non-reactive.Conclusions: Preventing congenital syphilis with the recommended treatment for gestational syphilis may fail.
Moreover, diagnosing this condition sten jacket m in an asymptomatic newborn is difficult.Therefore, clinical and serological tests are recommended to confirm whether maternal treatment was effective in the fetus.