Two Darkfield-Positive Reinfections in Treated Congenital Syphilis

To the Editor:—  There are well over 100 case reports in the literature of clinical reinfection in previously treated cases of congenital syphilis.^1-3 Very few reports, however, have mentioned substantiation of reinfections by the finding of Treponema pallidum in the sexually acquired lesions.In the Sing Sing Study of inoculation syphilis, Magnusen et al included five patients who were classified as having been adequately treated for congenital syphilis.⁴ However, only one had stigmata of congenital syphilis, and in the other four, the presumption of congenital infection was made on the not too satisfactory basis of a record of a positive serologic test for syphilis early in life.This letter reports two well-documented cases of patients with congenital syphilis, with confirmed treatment early in life, who present with darkfield-positive lesions of sexually acquired reinfections.

Report of Cases:—  Case 1.—The patient was a 25-year-old man seen on May 9, 1967,