{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:13:21Z","timestamp":1783530801302,"version":"3.55.0"},"reference-count":19,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004851","name":"European Union-NextGenerationEU, through the Medical University of Pleven, National Recovery and Resilience of the Republic of Bulgaria","doi-asserted-by":"publisher","award":["BG-RRP-2.004-0003"],"award-info":[{"award-number":["BG-RRP-2.004-0003"]}],"id":[{"id":"10.13039\/501100004851","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Lues remains a global health concern despite the well-known nature of its symptoms, the availability of diagnostic methods, and the existence of effective therapy. The recent increase in maternal syphilis has been accompanied by a rise in congenital infections, which are associated with stillbirth, prematurity, neonatal mortality, and severe multisystemic disorder. In newborns, it may present with highly variable clinical manifestations, making timely diagnosis and treatment essential. We report a case of severe early congenital syphilis in a premature newborn with extensive multiorgan involvement; Case Presentation: We present a case of a male infant born at 31 + 6 weeks of gestation to a 26-year-old mother with inadequate antenatal care and no documented screening or treatment for syphilis during pregnancy. Prenatal ultrasound revealed fetal ascites. At birth, the infant presented with severe respiratory failure requiring immediate resuscitation, endotracheal intubation, and intensive care support. Clinical findings included hepatosplenomegaly, generalized edema, ascites, petechial rash, palmoplantar desquamation, severe thrombocytopenia, anemia, coagulopathy, liver dysfunction, and hemorrhagic syndrome. Maternal and neonatal serologic testing confirmed syphilis infection. The clinical course was complicated by pneumonia with prolonged mechanical ventilation, cardiovascular involvement impairing cardiac function, and heart failure. Treatment consisted of intravenous penicillin G, broad-spectrum antimicrobial therapy, antifungal medication, respiratory support, transfusion therapy, cardiovascular management, and intensive multidisciplinary care; Conclusions: This report presents consequences of untreated maternal syphilis and underscores the importance of timely diagnosis, early initiation of penicillin therapy, and close multidisciplinary follow-up to optimize outcomes in neonates.<\/jats:p>","DOI":"10.3390\/reports9030214","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:40:09Z","timestamp":1783525209000},"page":"214","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe Early Congenital Syphilis with Multiorgan Involvement in a Preterm Neonate: A Case Report"],"prefix":"10.3390","volume":"9","author":[{"given":"Iva","family":"Prodanova","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University Pleven, 5800 Pleven, Bulgaria"},{"name":"Clinic of Neonatology, Dr. Georgi Stranski University Hospital, 5800 Pleven, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1126-8956","authenticated-orcid":false,"given":"Preslava","family":"Gatseva","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University Pleven, 5800 Pleven, Bulgaria"},{"name":"Clinic of Neonatology, Dr. Georgi Stranski University Hospital, 5800 Pleven, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hristiana","family":"Delvarska","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University Pleven, 5800 Pleven, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todor","family":"Vasilev","sequence":"additional","affiliation":[{"name":"Heart and Brain Hospital, 5800 Pleven, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Donev","sequence":"additional","affiliation":[{"name":"Clinic of Neonatology, Dr. Georgi Stranski University Hospital, 5800 Pleven, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"ref_1","first-page":"4","article-title":"Brief History of Syphilis","volume":"7","author":"Tampa","year":"2014","journal-title":"J. Med. Life"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1056\/NEJMra2202762","article-title":"Syphilis Complicating Pregnancy and Congenital Syphilis","volume":"390","author":"Stafford","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"324","DOI":"10.25122\/jml-2024-0363","article-title":"A Comprehensive Congenital Syphilis Case Report with Evidence-Based Insights into Current Practices","volume":"18","author":"Mohora","year":"2025","journal-title":"J. Med. Life"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Rosset, F., Celoria, V., Delmonte, S., Mastorino, L., Sciamarrelli, N., Boskovic, S., Ribero, S., and Quaglino, P. (2025). The Epidemiology of Syphilis Worldwide in the Last Decade. J. Clin. Med., 14.","DOI":"10.3390\/jcm14155308"},{"key":"ref_5","unstructured":"Eyal, F., and Bany-Mohammed, F. (2020). Gomella\u2019s Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, Mc Graw Hill. [8th ed.]."},{"key":"ref_6","unstructured":"Centers for Disease Control and Prevention (CDC) (2026, March 27). Sexually Transmitted Infections Treatment Guidelines: Congenital Syphilis, Available online: https:\/\/www.cdc.gov\/std\/treatment-guidelines\/congenital-syphilis.htm."},{"key":"ref_7","unstructured":"(2026, March 08). Syphilis. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/syphilis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.ajog.2016.11.1052","article-title":"Syphilis during Pregnancy: A Preventable Threat to Maternal-Fetal Health","volume":"216","author":"Rac","year":"2017","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_9","unstructured":"(2026, March 06). Congenital Syphilis\u2014Annual Epidemiological Report for 2023. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/congenital-syphilis-annual-epidemiological-report-2023."},{"key":"ref_10","unstructured":"Ministry of Health (2026, March 27). Regulation No. 3 of May 26, 2016, on the Procedures and Conditions for the Diagnosis, Prevention, and Control of Syphilis, Gonorrhea, and Urogenital Chlamydia Infection. Available online: https:\/\/lex.bg\/bg\/laws\/ldoc\/2136838736?__cf_chl_f_tk=xf4nAtsL_oHQ_D_03xQNNViPmgB80hqueDFtrg2__jc-1783360007-1.0.1.1-PboT62YnLPMXNiaz1wzTCoki6YQJg895XsjBxDBkxP0."},{"key":"ref_11","unstructured":"Ministry of Health (2026, March 27). REGULATION No. 8 of November 3, 2016, on Preventive Medical Examinations and Dispensary Care. Available online: https:\/\/lex.bg\/bg\/laws\/ldoc\/2136933195."},{"key":"ref_12","unstructured":"Ministry of Health (2026, March 27). Regulation No. H-1 of April 7, 2025, on the Procedures and Conditions for the Diagnosis, Prevention, and Control of Sexually Transmitted Infections. Available online: https:\/\/share.google\/yIXCQlQBBzTpxsnjP."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1080\/15513815.2018.1485798","article-title":"Fetal and Placental Pathology in Congenital Syphilis: A Comprehensive Study in Perinatal Autopsy","volume":"37","author":"Kittipornpechdee","year":"2018","journal-title":"Fetal Pediatr. Pathol."},{"key":"ref_14","unstructured":"Martin, R.J., Fanaroff, A.A., and Walsh, M.C. (2020). Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant, Elsevier. [11th ed.]."},{"key":"ref_15","first-page":"642","article-title":"An Uncommon Cause of Neonatal Respiratory Distress","volume":"52","author":"Dimitriou","year":"2010","journal-title":"Turk. J. Pediatr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"101780","DOI":"10.1016\/j.ppedcard.2024.101780","article-title":"Cardiovascular Disease Associated with Congenital Infections","volume":"76","author":"Sanchez","year":"2025","journal-title":"Prog. Pediatr. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"104613","DOI":"10.1016\/j.bjid.2026.104613","article-title":"Intracardiac mass in a 3-month-old boy revealing a congenital syphilis","volume":"30","author":"Barre","year":"2026","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_18","first-page":"e69849","article-title":"Early Congenital Syphilis Presenting with Severe Congenital Pneumonia and Cutaneous Manifestations in a Neonate at Birth: A Case Report","volume":"16","author":"Alqahtani","year":"2024","journal-title":"Cureus"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"F391","DOI":"10.1136\/archdischild-2017-313595","article-title":"Why Are Preterm Newborns at Increased Risk of Infection?","volume":"103","author":"Collins","year":"2018","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/3\/214\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:15:31Z","timestamp":1783527331000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/3\/214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":19,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["reports9030214"],"URL":"https:\/\/doi.org\/10.3390\/reports9030214","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]}}}