OBJECTIVE: Congenital Syphilis is infection of newborn caused by the bacterium Treponema pallidum. Pregnant women with the disease can transmit it through the placenta to the fetus or at birth to the neonate.1 About 70% of congenital syphilis are asymptomatic. Seizure is one of the symptom that can lead us to detect CNS involvement of the infection. Late management of the disease can lead to serious complication like neurosyphilis which can make serious symptoms, even can be fatal.2
CASE: A 15 days old male infant was complained by his mother had a seizure on both of her limbs one day before admitted to the hospital. He was also complained of vomiting about 5 times before seizures and patient had runny nose since birth. From history revealed the mother was VDRL and TPHA reactive and did not take any medication during the pregnancy. From the physical examination, rhinorrhea was found with mucopurulent nasal discharge. From laboratory findings revealed VDRL reactive 1:32 and TPHA reactive 1:640 in the baby. There is no abnormalities was found in long bone x-ray. Head CT scan was done and revealed a brain edema. CSF VDRL analysis was reactive 1:2. From these findings, the diagnosed of congenital syphilis was made. Treatment with intramuscular injection of Penicillin Procaine 200.000 units was started and continued for 10 days.
CONCLUSION: Infected newborn often do not show any sign or symptom at birth. All newborn to women who have reactive serologic tests for syphilis should be examined thoroughly for evidence of congenital syphilis. Non-treponemal tests (VDRL) are useful for initial screening and treponemal tests (TPHA) are confirmatory of the presence of the disease. CSF evaluation should be done for the patient to confirm meningovascular involvement of the infection. Initial and appropriate treatment will give a good result.