A neonate born at 34 weeks is noted to have jaundice at 18 hours, hepatosplenomegaly, a maculopapular rash on the palms and soles, snuffles, and pseudoparalysis of one arm. VDRL is reactive 1:32. What is the dose of benzathine penicillin G for confirmed congenital syphilis without CNS involvement?

• A 50,000 units/kg IM as a single dose ✓
• B 50,000 units/kg/day IV for 10 days
• C 2.4 million units IM as a single dose
• D 100,000 units/kg/day IV for 7 days

Explanation

For infants with possible congenital syphilis who are clinically normal but have inadequately treated mothers, benzathine penicillin G 50,000 units/kg IM as a single dose is the preferred regimen. However, for infants with confirmed or highly probable congenital syphilis with clinical signs (as in this case), the preferred regimen is aqueous crystalline penicillin G 100,000–150,000 units/kg/day IV (50,000 units/kg every 12 hours for the first 7 days, then every 8 hours for 10 days total). Benzathine penicillin 50,000 units/kg IM single dose is used for asymptomatic neonates born to inadequately treated mothers.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.