Hutchinson's triad

Congenital syphilis results from the transmission of Treponema pallidum (a spirochete bacteria) from an infected mother to the fetus.

[7] Interstitial keratitis is immune-mediated inflammation of the cornea, without an active corneal infection by Treponema pallidum bacteria.

Essentially, the patient’s immune cells over-activate, inducing a strong inflammatory reaction that damages the cornea.

The infection triggers several pathologic changes in the ear: These changes damage the spiral ganglion and cranial nerve 8 fibers, leading to progressive sensorineural hearing loss.

[4] In the United States, the Centers for Disease Control and Prevention recommends syphilis screening at the first prenatal visit, and again early in the third trimester for individuals at high risk of infection.

[11] Additionally, areas without testing facilities will not report cases due to a lack of resources rather than an absence of the disease.

[7] It generally presents in both eyes, and the patient experiences concurrent photophobia, pain, corneal opacity, and excessive tearing.

[16] However, if diagnosis of congenital syphilis is delayed until Hutchinson’s triad is noted–among other signs and symptoms, such as nasal cartilage destruction (saddle nose), frontal bossing, joint swelling (Clutton joints), tibial thickening (Saber shins), hard palate defect–the damage is irreversible.

Effective prevention requires routine prenatal screening, rapid treatment of all infected mothers, and partner tracing/treatment.

All infants with positive syphilis screenings should be treated immediately for improved long-term health outcomes, and should follow up regularly with their doctor for continued observation.