A SILENT THREAT: MULTISYSTEM CONGENITAL SYPHILIS IN A PRETERM NEONATE- A CASE REPORT AND CALL FOR ENHANCED PRENATAL SCREENING

Background: Congenital syphilis a preventable disease, continue to pose a signicant public health challenge globally. Despite advancements in maternal healthcare, inadequate screening and treatment during pregnancy have led to resurgence of this condition, resulting in severe neonatal complications. Case Presentation: A preterm female neonate, born at 33 weeks of gestation with birth weight of 1470 grams presented with respiratory distress requiring CPAP support. Clinical examination revealed distinctive copper-red maculopapular lesions over palms and soles with desquamation and signicant hepatosplenomegaly. Investigations: Laboratory studies showed anemia (Hb 10 g/dL), thrombocytopenia (platelets 75,000/ L), leukocytosis (WBC 84,000/ L), and cholestatic jaundice (total bilirubin 10.7 mg/dL, direct 4.1 mg/dL). Radiographs demonstrated metaphyseal demineralization. cerebrospinal uid analysis conrmed neurosyphilis with a reactive VDRL titer (1:4). Auditory assessment revealed bilateral hearing loss. Diagnosis and Treatment: The constellation of clinical and laboratory ndings conrmed early congenital syphilis with neurosyphilis. Treatment with intravenous aqueous crystalline penicillin G was initiated according to standard guidelines. Conclusion: This case underscores the critical importance of maternal syphilis screening during pregnancy, particularly in high incidence areas. Early diagnosis and treatment within the rst three months of life are essential to prevent long term sequelae and complications.