Syphilis can be staged into Primary, Secondary, and Tertiary syphilis according to

the progress of the disease. If a neonatal is born with syphilis, then we will call
this condition as congenital syphilis.
Syphilis is an STD caused by spirochete bacterium called Treponema pallidum.
The reason why the incidence of syphilis is rising is due to HIV infection and IV
drug abuser.
Frequency of vertical transmission, or the frequency of transmission from mother
to her fetus is different with the stage of syphilis of a mother. For example
As you can see, at syphilis progress earlier in the mother, the least like her fetus
is to be infected with syphilis
Clinical features
This is why the general examination is important so that we dont miss out these
signs. Usually patient wont complain about these abnormalities because they
are not painful.
Jarisch-Herxheimer Reaction is an acute febrile reaction due to a rapid release of
treponemal antigen with an associated allergic reaction in the patient.
Accompanied by headache, myalgia, fever, and inflammatory reaction at the
sites of infection.
Usually occurs among patients with early syphilis.
Transmission to fetus
Historically, pregnancy was considered an immunosuppressive state, which
allowed the fetal to implant and develop. However, it is now accepted that the
placental barrier is imperfect, with bidirectional traffic of all types of maternal
and fetal cells across it.
As you can see from this diagram, besides oxygen and nutrients, placental
barrier also allows bacterium like Treponema pallidum, drugs, or viruses like
rubella.
Complication
Diagnosis
Seropositive pregnant women should be considered infected unless an adequate
treatment history is documented clearly in the medical records and sequential
serologic antibody titers have declined appropriately for the stage of syphilis
If a treponemal test (e.g., EIA or CIA) is used for antepartum syphilis screening,
all positive EIA/CIA tests should be reflexed to a quantitative nontreponemal test
(RPR or VDRL). If the nontreponemal test is negative, then the results are
considered discrepant and a second treponemal test (TP-PA preferred) should be
performed, preferably on the same specimen
If both the RPR and TP-PA remain negative, no further treatment is necessary. If
follow-up is not possible, women without a history of treated syphilis should be
treated according to the stage of syphilis.

Principle of management