A 2-month-old boy is brought to the physician by his parents because of a 1-week history of increased fussiness and a rash. Initially, the rash was bright and copper-red but gradually started to fade and peel off. The patient has been feeding poorly and has not gained much weight since birth. He was born at 38 weeks gestation via an uncomplicated vaginal delivery and had an unremarkable neonatal course with no history of birth trauma or excessive bleeding. The mother had inconsistent prenatal care. He cries but calms when his mother picks him up. He is at the 3rd percentile for length and weight. Vital signs are within normal limits. Examination shows diffuse erythematous plaques on the soles and buttocks with desquamation. There is nasal congestion and a white nasal discharge. The liver is palpated 3 cm below the right costal margin. Which of the following is the most likely cause of this patient's illness?

Question

A 2-month-old boy is brought to the physician by his parents because of a 1-week history of increased fussiness and a rash. Initially, the rash was bright and copper-red but gradually started to fade and peel off. The patient has been feeding poorly and has not gained much weight since birth. He was born at 38 weeks gestation via an uncomplicated vaginal delivery and had an unremarkable neonatal course with no history of birth trauma or excessive bleeding.  The mother had inconsistent prenatal care.  He cries but calms when his mother picks him up. He is at the 3rd percentile for length and weight. Vital signs are within normal limits. Examination shows diffuse erythematous plaques on the soles and buttocks with desquamation. There is nasal congestion and a white nasal discharge. The liver is palpated 3 cm below the right costal margin. Which of the following is the most likely cause of this patient's illness?

Quizplus · Accepted Answer

Eductional Objective: Congenital syphilis is acquired via transplacental transmission of the spirochete Treponema pallidum and may present with pain and limited extremity movement due to long bone involvement (eg, metaphyseal erosions, periosteal inflammation).  Nonspecific manifestations include hepatosplenomegaly and lymphadenopathy.

A 2-Month-Old Boy Is Brought to the Physician by His