Congenital Syphilis: Treatment and Implications for Newborns

Congenital Syphilis in Newborns

Hello doctor, I had a syphilis infection during my pregnancy, so I brought my baby in for a blood test after she was born.
The results showed an RPR of 1:4, and the hospital wants us to be admitted.
Can my baby recover after treatment? Will there be any effects on her? Also, I had my first blood test in April with an RPR of 1:32 and completed three doses of treatment.
In August, my RPR was 1:4.
However, last week, my RPR was 1:128, and my TPPA skyrocketed to over 40,000.
My husband and I have not had sexual intercourse, and I have no other partners.
Why is this happening...?

yu, 20~29 year old female. Ask Date: 2023/11/01

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your inquiry.
Your question pertains to infectious diseases, and I recommend that you consult with an infectious disease specialist.
The Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, is concerned about your well-being.

Reply Date: 2023/11/01

More Info

Congenital syphilis is a serious condition that occurs when a mother with syphilis transmits the infection to her baby during pregnancy. It can lead to a range of health issues for the newborn, including physical deformities, developmental delays, and even life-threatening complications if not treated promptly. Given your situation, it is crucial to understand the implications of congenital syphilis, the treatment options available, and the potential outcomes for your baby.

Firstly, the RPR (Rapid Plasma Reagin) test is a non-treponemal test used to screen for syphilis. The results you provided indicate fluctuating levels of RPR, which can happen due to various factors, including the effectiveness of treatment and the body's response to the infection. The TPPA (Treponema pallidum particle agglutination) test is a more specific test for syphilis, and a high level suggests that the infection is still present or that there has been a reinfection.

In your case, the newborn's RPR result of 1:4 indicates that there is still some level of the infection present, which is why the hospital has recommended hospitalization for further evaluation and treatment. The treatment for congenital syphilis typically involves administering penicillin, which is highly effective in treating the infection. The duration and dosage of treatment will depend on the severity of the infection and the clinical presentation of the baby.

If treated appropriately, many infants can recover fully from congenital syphilis without long-term effects. However, if the infection is not treated, it can lead to severe complications, including neurological issues, bone deformities, and other systemic problems. Therefore, it is essential to follow the medical team's recommendations closely and ensure that your baby receives the necessary treatment.

Regarding your concerns about the fluctuating RPR results and the high TPPA levels, it is important to communicate openly with your healthcare provider. They can help clarify why these results may have occurred despite your lack of sexual activity and provide guidance on the next steps. It is possible that the initial infection during pregnancy has led to these results, and your healthcare provider can explain the implications of these findings in detail.

In summary, congenital syphilis is a serious condition that requires prompt and effective treatment to prevent long-term complications. With appropriate medical care, your baby has a good chance of recovering fully. It is crucial to maintain open communication with your healthcare team, follow their recommendations, and ensure that your baby receives the necessary treatment and follow-up care. This will help address any concerns you may have and provide the best possible outcome for your child's health.

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