April is STD (Sexually Transmitted Disease) / STI (Sexually Transmitted Infection) Awareness Month! (Part II: Congenital Syphilis)


Earlier this month we posted some general information regarding STD Awareness Month. This time, we’d like to focus on one particular infection whose rates are rising very significantly: congenital syphilis.

What is Syphilis?

Syphilis is a bacterial infection that is part of the STORCH (Syphilis, Toxoplasmosis, Other, Rubella, Cytomegalovirus, and Herpes simplex virus) group of infections, which are very commonly related to intrauterine infections.

These intrauterine infections might not necessarily present themselves with symptoms in the mother, but can still have very devastating consequences in the child if left untreated. These infections enter the baby through the mother’s bloodstream, or during passage through the birth canal. This can result in hydrocephalus, intrauterine growth restriction (IUGR), premature birth, and, in some cases, fetal death. Infants may pass away, or be left with catastrophic permanent developmental disabilities.

Why is Syphilis Such a Concern Right Now?

Syphilis rates are rising astronomically in the United States, with infection rates rising 15% in a single year between 2013 and 2014. Congenital syphilis cases increased 27.5% in that same time frame, making raising awareness of syphilis’ ill effects on newborn babies an urgent matter of public health. Between 2012 and 2014, this rate increased a total of 38%.

Congenital syphilis cases are ‘sentinel events,’ which demonstrate that, in these cases, there were very significant missed opportunities for preventing:

  •         Syphilis infection in pregnant women or women who then became pregnant
  •         Mother-to-infant transmission of the syphilis infection

This means that these situations demonstrate clear medical negligence.

What Does Congenital Syphilis Look Like?

Infected children might not show symptoms at birth or may have signs of disseminated sepsis (blood infection throughout the body).

In some cases, this syphilis infection can turn into neurosyphilis, which is a bacterial infection of the brain and/or spinal cord. When infants have neurosyphilis, it can present itself as meningitis, glaucoma, chorioretinitis, chancres or uveitis. If left untreated, it can cause severe developmental impairments.

Other signs of syphilis in newborns include:

  •         Failure to thrive
  •         Fever
  •         Irritability
  •         Hepatosplenomegaly (liver and spleen swelling)
  •         Saddle nose (middle of nose bowed inward due to weakened nasal support)
  •         Syphilitic rash
  •         Watery fluid coming from the nose
  •        Jaundice
  •         Liver and spleen swelling and bone inflammation (seen in physical exams)

How Do Parents Make Sure Their Newborn Does Not Suffer a Birth Injury from an STI?

The best way for parents to be involved in making sure that their child does not get an infection passed to them is to have routine screening tests during prenatal care during the first visit. For higher-risk populations, these tests should occur again at 28 weeks’ gestation and delivery.

The most effective way to prevent a child from getting an infection of this type is to diagnose it in the mother with routine prenatal screenings, and then to prescribe appropriate medications to treat infection. First, mothers are screened with non-specific treponemal tests; if those tests come up positive, physicians perform more specific tests. Some of these tests include fluorescent treponemal antibody absorbed test (FTA-ABS), rapid plasma reagin (RPR) or venereal disease research laboratory tests (VDRL).

The earlier an infection is caught, the better the prognosis, especially before 16 weeks gestation. Administration of antibiotic treatments (usually a form of penicillin called benzathine penicillin G) as early as possible is indicated for syphilis infection. Indeed, this form of treatment is 98% effective at preventing congenital syphilis.

If the infection is not caught in the mother during pregnancy or before labor, tests on the baby (called Serum IgM tests) can tests positive for infection up to 90% of the time. There are numerous other tests for syphilis, including FBE, liver function tests, syphilis serology, urinalysis (to detect proteinuria), bone X-rays, dark-field examinations (for detecting the bacteria), and lumbar puncture.

Congenital Syphilis and Birth Injuries

It is clear that, in the case of congenital syphilis, the failure to catch or treat the infection at multiple points is often medical negligence or malpractice, as there are numerous opportunities to prevent the infection from being transmitted to the baby. This means that there were opportunities to prevent serious health conditions such as
chorioamnionitis and villitis, which can cause lack of blood flow and oxygen deprivation (hypoxic ischemic encephalopathy) and cerebral palsy in newborn babies.

logo If you believe that your child’s developmental delays, cerebral palsy or neurological injuries occurred due to a physician’s mismanagement of a maternal infection, please contact Reiter & Walsh P.C. Our dedicated birth injury attorneys and medical staff can review your medical records to see if medical malpractice occurred and help you  provide your child with the lifelong care they need.

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