Neonatology pp 1703-1710 | Cite as

Fetal Infections: Congenital Syphilis and Tuberculosis

  • Pier Angelo TovoEmail author
  • Carlo Scolfaro
  • Silvia Garazzino
  • Federica Mignone
Reference work entry


Syphilis is a major public health problem in developing countries, and it is also resurging in the industrialized world. Congenital tuberculosis (TB) is rare, but it may be fatal if untreated. Infection of the fetus may be the consequence of hematogenous spread, aspiration or ingestion of contaminated amniotic fluid, or contact with maternal genital lesions at delivery. In infants signs and symptoms may be nonspecific, mimicking other disseminated infections. Early recognition is essential for a prompt treatment, as the mortality rate of untreated forms is approximately 50%. Initial therapy consists in the combination of four first-line antituberculous drugs, although the optimal regimen and duration of treatment remain to be established.


  1. Baquero-Artigao F, Mellado Peña MJ, Del Rosal Rabes T et al (2015) Spanish Society for Pediatric Infectious Diseases guidelines on tuberculosis in pregnant women and neonates (I): epidemiology and diagnosis. Congenital tuberculosis. An Pediatr 83:285.e1–285.e8CrossRefGoogle Scholar
  2. Centers for Disease Control and Prevention (2015a) Increase in incidence of congenital syphilis – United States, 2012–2014. Morb Mortal Wkly Rep 64:1241–1245CrossRefGoogle Scholar
  3. Centers for Disease Control and Prevention (2015b) Sexually transmitted diseases treatment guidelines. Morb Mortal Wkly Rep 64:34–49Google Scholar
  4. Centers for Disease Control and Prevention (2016) Available at
  5. Centers for Disease Control and Prevention (CDC) (2009) Sexually transmitted disease surveillance 2007 supplement, syphilis surveillance report. U.S. Department of Health and Human Services, Atlanta, Available at
  6. Clement ME, Okeke NL, Hicks CB (2014) Treatment of syphilis: a systematic review. JAMA 312:1905–1917CrossRefGoogle Scholar
  7. Di Comite A, Esposito S, Villani A et al (2016) How to manage neonatal tuberculosis. J Perinatol 36:80–85CrossRefGoogle Scholar
  8. Doroshenko A, Sherrard J, Pollard AJ (2006) Syphilis in pregnancy and the neonatal period. Int J STD AIDS 17:221–228CrossRefGoogle Scholar
  9. Follett T, Clarke DF (2011) Resurgence of congenital syphilis: diagnosis and treatment. Neonatal Netw 30:320–328CrossRefGoogle Scholar
  10. Galli L, Lancella L, Garazzino S et al (2016) Recommendations for treating children with drug-resistant tuberculosis. Pharmacol Res 105:176–182CrossRefGoogle Scholar
  11. Garazzino S, Galli L, Chiappini E et al (2014) Performance of interferon-γ release assay for the diagnosis of active or latent tuberculosis in children in the first 2 years of age: a multicenter study of the Italian Society of Pediatric Infectious Diseases. Pediatr Infect Dis J 33:e226–e231CrossRefGoogle Scholar
  12. Ingall D, Sanchez PJ, Baker CJ (2006) Syphilis. In: Remington JS, Klein JO (eds) Infectious diseases of the fetus and newborn infant, 6th edn. Elsevier Saunders, Philadelphia, pp 545–580CrossRefGoogle Scholar
  13. Kingston M, French P, Higgins S et al (2015) UK National guidelines on the management of syphilis 2015. Int J STD AIDS pii: 0956462415624059. [Epub ahead of print]Google Scholar
  14. Lautenschlager S (2006) Diagnosis of syphilis: clinical and laboratory problems. JDDG 12:1058–1072CrossRefGoogle Scholar
  15. Mignone F, Codecasa LR, Scolfaro C et al (2013) The spread of drug-resistant tuberculosis in children: an Italian case series. Epidemiol Infect 142:2049–2056CrossRefGoogle Scholar
  16. National Institute for Health and Care Excellence (2016) Tuberculosis prevention, diagnosis, management and service organisation NICE guideline, No. 33 Internal Clinical Guidelines Team (UK). National Institute for Health and Care Excellence (UK), LondonGoogle Scholar
  17. Patel S, DeSantis ER (2008) Treatment of congenital tuberculosis. Am J Health Syst Pharm 65:2027–2031CrossRefGoogle Scholar
  18. Shahrook S, Mori R, Ochirbat T et al (2014) Strategies of testing for syphilis during pregnancy. Cochrane Database Syst Rev 10, CD010385Google Scholar
  19. Smith KC (2002) Congenital tuberculosis: a rare manifestation of a common infection. Curr Opin Infect Dis 15:269–274CrossRefGoogle Scholar
  20. Starke J (2006) Tuberculosis. In: Remington S, Baker CJ, Klein JO, Wilson CB (eds) Infectious diseases of the fetus and newborn infant. W B Saunders Co, Philadelphia, pp 581–597CrossRefGoogle Scholar
  21. Walker GJ, Walker DG (2007) Congenital syphilis: a continuing but neglected problem. Semin Fetal Neonatal Med 12:198–206CrossRefGoogle Scholar
  22. Whittaker E, Kampmann B (2008) Perinatal tuberculosis. New challenges in the diagnosis and treatment of tuberculosis in infants and the newborn. Early Hum Dev 84:795–799CrossRefGoogle Scholar
  23. World Health Organisation (2003) Guidelines for the management of sexually transmitted infections (ISBN 92 4 154626 3). World Health Organization, GenevaGoogle Scholar
  24. World Health Organization (2008) Global incidence and prevalence of selected curable sexually transmitted infections (ISBN: 978 92 4 150383 9). World Health Organization, GenevaGoogle Scholar
  25. World Health Organization (2015) Global tuberculosis report 2015 (Publication no. WHO/HTM/TB/2015.22). World Health Organization, GenevaGoogle Scholar
  26. Zeltser R, Kurban AK (2004) Syphilis. Clin Dermatol 22:461–468CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Pier Angelo Tovo
    • 1
    Email author
  • Carlo Scolfaro
    • 1
  • Silvia Garazzino
    • 1
  • Federica Mignone
    • 1
  1. 1.Department of PediatricsUniversity of Turin, Regina Margherita Childrens Hospital, AOU Città della Salute e della Scienza di TorinoTurinItaly

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