Depending on the severity of in-utero infection, late abortion, stillbirth, neonatal death, neonatal disease or latent infection may occur.
In the peri-natal period, rhinitis followed by a maculopapular desquamatative rash are classic external signs. Severe hepatitis and osteochondritis/periostitis are common.
Untreated children who survive enter a latent period and go on to develop the late lesions of syphilis, a result of chronic inflammation of their bones, cartilage, eyes, ears and internal organs.
Congenital syphilis: rash at 7 days, year 1949.
Spirochaetes in a section of liver from a patient with congenital syphilis, Warthin-Starry stain. Image source: Wellcome library, London The high rate of venereal and congentital syphilis was a hazard for midwives. This chancre on the finger,
was the result of an accidental infection of a midwife - year unknown.
Stigmata of late congenital syphilis in a girl at age 16 years, year 1942.
General wasting, enlarged liver, gumma of the frontal bone, Hutchinson’s teeth, gummatous ulcer of palate
Stigmata of late congenital syphilis in a boy at age 15 years, year 1943.
Saddle nose, Clutton’s joints, Hutchinson’s teeth and chronic interstitial keratitis i.e. chronic, nonulcerative inflammation of the corneal stroma (the middle layers of the cornea), without involvement of either the epithelium or endothelium.
Sabre tibia in a young boy, year 1929