DISCUSSION
Humans are the only source for syphilis, with most infections due to sexual intercourse. Few individuals are infected indirectly such as by blood transfusion or close contact. For young children, there is often no history of sexual contact or abuse. Such cases are rare and can be easily misdiagnosed or missed. This case was initially misdiagnosed as eczema. It has been reported that close contact with children infected with syphilis, especially in overcrowded or poor family situations, increases the risk of close sexual transmission of syphilis. Infected family members or caregivers are a particular risk for children.4
The child reported herein was healthy, with no hereditary disease, no history of surgery, blood transfusion, or sexual assault. Her mother tested negative for syphilis during pregnancy. To determine the source of infection and mode of transmission, close contacts were tested. Her parents, two grandparents, and a grandmother were serologically negative for syphilis. However, one grandfather was TPPA and RPR positive. Based on this information, it can be inferred that this case of syphilis was due to close contact during daily life.