Congenital syphilis is syphilis present in utero and at birth, and occurs when a child is born to a mother with syphilis. It is caused by the spirochete Treponema pallidum. Babies typically have facial abnormalities such as rhagades (linear scars at the angle of the mouth), snuffles (nasal discharge), saddle nose, notched (Hutchinson) teeth, mulberry molars, and a short maxilla. Other features include saber shins and cranial nerve VIII deafness. It can be prevented by treating the mother early in pregnancy as placental transmission occurs after the first trimester. Treatment is with 10-14 days of penicillin G.