Symptoms:

Symptoms in newborns may include:

• Failure to gain weight or failure to thrive
• Fever
• Irritability
• No bridge to nose (saddle nose)
• Early rash -- small blisters on the palms and soles
• Later rash -- copper-colored, flat or bumpy rash on the face, palms, and soles
• Rash of the mouth, genitalia, and anus
• Watery discharge from the nose

Symptoms in older infants and young children may include:

• Abnormal notched and peg-shaped teeth, called Hutchinson teeth
• Bone pain
• Blindness
• Clouding of the cornea
• Decreased hearing or deafness
• Gray, mucus-like patches on the anus and outer vagina
• Joint swelling
• Refusal to move a painful arm or leg
• Saber shins (bone problem of the lower leg)
• Scarring of the skin around the mouth, genitalia, and anus

Signs and tests:

If the disorder is suspected at the time of birth, the placenta will be examined for signs of syphilis. A physical examination of the infant may show signs of liver and spleen swelling and bone inflammation.

A routine blood test for syphilis is done during pregnancy. The mother may receive the following blood tests:

• Fluorescent treponemal antibody absorbed test (FTA-ABS)
• Rapid plasma reagin (RPR)
• Venereal disease research laboratory test (VDRL)

An infant or child may have the following tests:

• Bone x-ray
• Eye examination
• Lumbar puncture
• Dark-field examination to better detect syphilis-related bacteria under a microscope