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.