A newborn premature baby presented with bullous lesions on skin and legs, Xray shows features suggestive of periostitis. Which of the following is the initial investigation?
High-Yield Explanation
The newborn baby has characteristic signs and symptoms of congenital syphilis. Periostitis is a hallmark of skeletal manifestation. VDRL/RPR is the initial investigation of choice in congenital syphilis. All neonates born to mothers who have reactive nontreponemal and treponemal test results should be evaluated with a quantitative nontreponemal serologic test (RPR or VDRL) performed on the neonate's serum, because umbilical cord blood can become contaminated with maternal blood and yield a false-positive result. FTA-ABS/TPHA are used for confirmation of syphilis in a patient with reactive RPR/VDRL test. T. pallidum cannot be detected by culture. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition