Congenital syphilis is syphilis present in utero and at birth, and occurs when a child is born to a mother with syphilis. Untreated early syphilis infections results in a high risk of poor pregnancy outcomes, including saddle nose, lower extremity abnormalities, miscarriages, premature births, stillbirths, or death in newborns. Some infants with congenital syphilis have symptoms at birth, but many develop symptoms later. Symptoms may include rash, fever, an enlarged liver and spleen, and skeletal abnormalities. Newborns will typically not develop a primary syphilitic chancre but may present with signs of secondary syphilis (i.e. generalized body rash). Often these babies will develop syphilitic rhinitis ("snuffles"), the mucus from which is laden with the T. pallidum bacterium, and therefore highly infectious. If a baby with congenital syphilis is not treated early, damage to the bones, teeth, eyes, ears, and brain can occur. Classification
Early
This is a subset of cases of congenital syphilis. Newborns may be asymptomatic and are only identified on routine prenatal screening. If not identified and treated, these newborns develop poor feeding and runny nose. By definition, early congenital syphilis occurs in children between 0 and 2 years old. After, they can develop late congenital syphilis. Late
Late congenital syphilis is a subset of cases of congenital syphilis.
Bacillary angiomatosis (BA) is a form of angiomatosis associated with bacteria of the genus Bartonella. Symptoms
Cutaneous BA is characterised by the presence of lesions on or under the skin. Appearing in numbers from one to hundreds, these lesions may take several forms:
papules or nodules which are red, globular and non-blanching, with a vascular appearance
purplish nodules sufficiently similar to Kaposis sarcoma that a biopsy may be required to verify which of the two it is
a purplish lichenoid plaque
a subcutaneous nodule which may have ulceration, similar to a bacterial abscessWhile cutaneous BA is the most common form, it can also affect several other parts of the body, such as the brain, bone, bone marrow, lymph nodes, gastrointestinal tract, respiratory tract, spleen, and liver. Symptoms vary depending on which parts of the body are affected; for example, those whose livers are affected may have an enlarged liver and fever, while those with osseous BA  experience intense pain in the affected area. Presentation
BA is characterised by the proliferation of blood vessels, resulting in them forming tumour-like masses in the skin and other organs. Causes
It is caused by either Bartonella henselae or B. quintana. B.  henselae is most often transmitted through a cat scratch or bite, though ticks and fleas may also act as vectors. B. quintana is usually transmitted by lice.It can manifest in people with AIDS and rarely appears in those who are immunocompetent. Diagnosis
Diagnosis is based on a combination of clinical features and biopsy. Neutrophilic infiltrate.