4. Early Congenital Syphilis
Hepatomegaly is present in nearly all infants with CS, while splenomegaly is present in half of cases. Jaundice has been recorded in 33% of cases, as a consequence of syphilitic hepatitis or of hemolytic anemia [2, 22]. Elevated serum transaminase and alkaline phosphatase concentrations and direct hyperbilirubinemia can occur; the prothrombin time may be prolonged [23–25]. Generalized lymphadenopathy has been described in 50% of patients. Large epitrochlear nodes are typical of CS [22].