Congenital Syphilis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Congenital Syphilis?
A neonatologist, a doctor for newborn babies, usually treats congenital syphilis. A pediatric infectious disease doctor, a children's infection specialist, may also help. Penicillin is the drug of choice for treating this infection. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is congenital syphilis?
Congenital syphilis is a severe, disabling, and often life-threatening infection. It is seen in infants whose mothers were infected with syphilis and not fully treated. The infection can pass through the placenta to the unborn infant during pregnancy.
Symptoms
Most babies who are infected before birth appear normal. Over time, symptoms may develop. A baby may show no signs at birth. Serious problems can start within a few weeks without prompt treatment. In babies younger than 2 years old, symptoms may include:
- An enlarged liver or spleen.
- Failure to gain weight, or low birth weight.
- Fever and irritability.
- Cracked, irritated skin around the mouth, genitals, and anus.
- A rash that starts as small blisters, especially on the palms and soles.
- Bone problems, or not being able to move a painful arm or leg.
- Watery fluid from the nose.
- Jaundice and anemia.
Older infants and young children may have notched, peg-shaped teeth, called Hutchinson teeth. They may also have bone pain, joint swelling, or a flattened nasal bridge called saddle nose. Other problems include decreased hearing or deafness, clouding of the cornea, and blindness.
Causes and who gets it
Congenital syphilis is caused by the bacterium Treponema pallidum. It can pass from mother to child during fetal development or at birth. A pregnant woman with syphilis can pass it to her baby. Syphilis can cause miscarriage, stillbirth, or the baby's death soon after birth. Babies born with congenital syphilis in 2022 were more than 10 times the number in 2012.
How doctors diagnose it
All pregnant women get a routine blood test for syphilis. If infection is suspected at birth, the placenta is examined for signs of syphilis. A physical exam may show a swollen liver and spleen and bone inflammation.
A baby whose mother had syphilis may have these tests:
- A bone x-ray.
- A dark-field exam, which finds syphilis bacteria under a microscope.
- An eye exam.
- A lumbar puncture, also called a spinal tap, to remove spinal fluid for testing.
- Blood tests.
Treatment
Penicillin is the drug of choice for treating this infection. It may be given through a vein, called IV, or as a shot. Treating the mother lowers the risk of congenital syphilis in the baby. Pregnant women with syphilis need to be treated right away with penicillin. Treatment in the second half of pregnancy carries a risk of premature labor and problems for the unborn baby.
Without treatment, problems can include blindness, deafness, and nervous system problems.
When to see a doctor
Contact your child's health care provider if your baby has signs or symptoms of this condition. Untreated syphilis in babies can cause developmental delays, seizures, or death. Call 911 or go to the emergency room if a baby has a seizure. Do the same for trouble breathing or a baby who is hard to wake.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. If you may have syphilis and are pregnant, contact your provider right away to be tested.
Common questions
Is congenital syphilis life-threatening?
Yes, it is often life-threatening. Up to half of all babies infected with syphilis in the womb die shortly before or after birth.
Can a baby with congenital syphilis look healthy at birth?
Yes, most babies who are infected before birth appear normal. Symptoms may develop over time.
Can congenital syphilis be cured?
Yes, it can be cured with antibiotics if it is caught early. Penicillin is the drug of choice for treating this infection.
Can congenital syphilis be prevented?
Yes, prenatal care and routine blood tests for syphilis help prevent it. These tests find infected mothers so they can be treated. This lowers the risks to the baby and to the mother. Infants born to infected mothers who received proper antibiotic treatment during pregnancy are at minimal risk.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
