[Congenital syphilis after reactivation of "healed" maternal primary infection]

[Not a fall--not abuse--not a rare finding?]

A baby was brought into the accident and emergency department with X-ray pictures and with a plaster cast in place because of a pain reaction in the right arm. The pictures showed destruction of the epiphyseal region and double periosteal contours. Alterations of the same kind were found in all long bones; they were recognized as compatible with florid congenital syphilis, which was confirmed by reference to the history and the laboratory findings and was successfully treated with penicillin G in the pediatric department. Both parents were also treated. No traumatological/orthopedic treatment was given, and the plaster cast was removed. Following recognition of the signs described a complete cure was possible.