Ref Number = PITIKA-ASPR0133
Faisal Ambar, Hery D. Nawing
Congenital syphilis is acquired by an infant from an infected mother by transplacental transmission of  Treponema pallidum during pregnancy or possibly at birth from contact with maternal lesions. Untreated syphilis in pregnancy have 41% risk of giving birth to a live and infected infant, and only a 20% chance of giving birth to a healthy, uninfected infant. Infected infants may experience spesific symptoms , including Sadle Nose, Hutchinson teeth, Saber shins, interstitial keratitis, and gumma in palatum and nose. Somewhile, infected newborn often do not develop sign or symptoms at birth. The complication of congenital syphilis is neurosyphilis,which can be found a positive serologic test(VDRL)in cerebrospinal fluid. Here, we present a case of asymptomatic congenital syphilis in a newborn baby and its confirmation with serological tests  (TPHA) as early detection in limited facilitates regions.
To report a case of asimptomatic congenital syphilis in a term baby boy
We reported a case of congenital syphilis in a term baby born from mother with  untreated reactive syphilis.  The baby was born through c-section and showed no manifestations of syphilis congenital. Diagnosis was established  based on maternal history and the baby’s positive TPHA test. The baby was treated with Penicillin procain 150.000 unit / 24 hour/ intramuscular. The prognosis of this case is dubious. 
Learning points/discussion
Most syphilis infected infants are asymptomatic at birth, and so the diagnosis is presumptive and based on serological and clinical features. Diagnosis and management of congenital syphilis should be based on maternal history, clinical findings and nontreponemal (VDRL) and treponemal testing (TPHA).
Keywords: Congenital Syphillis, Treponema pallidum, Penicillin procain, VDRL, TPHA, sadle nose
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