Congenital syphilis is unlikely in following scenario-
Any neonate who has a normal physical examination and a serum quantitative nontreponemal serologic titer (VDRL) equal to or less than four-fold the maternal titre and both of the following criteria are met-
- mother’s treatment was adequate before pregnancy and
- mother’s nontreponemal serologic titre remained low and stable before and during pregnancy and at delivery (VDRL <1:2; RPR <1:4).
No further Evaluation is Recommended in above scenario.
But asymptomatic and clinically normal infants with a reactive nontreponemal tests should be followed serologically to ensure the nontreponemal test returns to negative. Benzathine penicillin G 50,000 units/kg as a single IM injection might be considered, particularly if follow-up is uncertain
Post Pic Credits Dr Sudheer M.S.,M.P. Silveira, in Indian Pediatrics October 2002
Pediatric Practice... Pearls for your Pediatric Office Practice 