Neonatal and post-neonatal onset of early congenital syphilis: a report from Mozambique.

Congenital syphilis (CS) has been and continues to be a principal public health problem in developing countries. Despite the wide experience acquired, physicians still have problems in diagnostic evaluation. We report 145 cases of CS at the Central Hospital, Maputo, emphasizing the differences in clinical features and in the results of serological and X-ray examinations between the neonatal and post-neonatal age groups. In the post-neonatal age group, the clinical expression of CS is mostly overt. It is commonly recognized that manifestations of CS in the neonatal age group are often poor or negative, yet a relevant percentage of CS that we report were fully symptomatic. In the neonatal age, the Venereal Disease Research Laboratory (VDRL) test in the mother and characteristic osteochondritic lesions on X-ray examination of the long bones help to make the diagnosis; in the post-neonatal age group, the VDRL test in the child is more often positive than in the mother and X-ray examination shows most periostitic lesions.