Congenital Syphilis and Necrotizing Funisitis-Reply

In Reply.—  Some of Dr Benirschke's criticisms of our article can be answered by saying that the format of a Brief Report in JAMA simply does not provide the space necessary for a complete literature review and inclusion of all data that might be desired.The diagnosis of congenital syphilis in our series was based on the combination of serological and anatomic findings for which we systematically searched: changes consistent with syphilis were present in each of the infants and in each of their placentas. The anatomic criteria for the diagnosis of syphilis are given in the first five references cited. They are suited to postmortem diagnosis, whereas the excellent article by Rathbun¹ cited in Dr Benirschke's letter was neither intended for that purpose nor can it be so applied. In it, the author states, and we concur with her, that negative reagin tests do not exclude congenital syphilis.