No infant should leave the hospital without the serologic status of the infant's mother having been documented at least once during pregnancy. Serologic testing also should be performed at delivery in communities and populations at risk for congenital syphilis.
Serologic tests can be nonreactive among infants infected late during their mother's pregnancy.
Infants with clinically evident congenital syphilis should have an ophthalmologic examination. Other causes of elevated values also should be considered when an infant is being evaluated for congenital syphilis. The infant should be treated if test results cannot exclude infection. The absence of a fourfold greater titer for an infant cannot be used as evidence against congenital syphilis. If more than 1 day of therapy is missed, the entire course should be restarted.