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Peer reviewedOpen accessSyphilisCongenital syphilis

State-of-the-Art Review: Congenital Syphilis in the Modern Era: Current Strategies and Future Directions

Clinical Infectious Diseases·

John M Flores, Ryan Rochat, Irene A Stafford, Cassandra Heiselman, Sharon Nachman, Jason Zucker

DOI
10.1093/cid/ciaf504
PMID
41638217
PMCID
OpenAlex
W7128027384
Study type
Journal article
Publisher
Oxford University Press (OUP)
Article type
journal-article
Integrity
current

Why this research matters now

The unprecedented surge in congenital syphilis cases underscores the need for improved prenatal screening, timely maternal treatment, and enhanced diagnostic capacity to prevent serious long-term sequelae in affected infants.

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Structured evidence summary

Research question

This review addresses the clinical presentation, diagnostic approaches, and treatment strategies for congenital syphilis in the context of a recent surge in cases.

Study design

State-of-the-art review synthesizing current knowledge on congenital syphilis diagnosis and management.

Population and setting

The review focuses on pregnant individuals with syphilis, their fetuses, and infants with congenital syphilis, including both symptomatic and asymptomatic presentations at birth.

Main findings

Cases of vertical syphilis transmission have increased more than tenfold in the past decade. Most affected infants are asymptomatic at birth, though nearly any organ system may be injured. Diagnosis relies on clinical presentation, serologic testing of both infant and pregnant individual, radiographic imaging, cerebrospinal fluid and blood markers, and maternal treatment history. Delayed morbid effects may emerge years after birth due to ongoing inflammation.

Public-health relevance

The unprecedented surge in congenital syphilis cases underscores the need for improved prenatal screening, timely maternal treatment, and enhanced diagnostic capacity to prevent serious long-term sequelae in affected infants.

Important limitations

This summary is limited to the supplied single-article abstract and bibliographic metadata. The full review article is required for decision-grade interpretation of the diagnostic algorithms, treatment protocols, and future research directions discussed.

GIDS interpretation

This review provides clinical and diagnostic context for congenital syphilis. It describes the complexity of case identification, including the challenge that most infants lack symptoms at birth and the multifactorial diagnostic approach required. The documented tenfold increase in cases over ten years offers background for interpreting reporting trends, though the review itself does not analyze surveillance data or attribute causality to specific interventions.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 12 auditable classifier relationships to diseases, places, topics, and study design.

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