Sources & methods
Trace the recommendation.
The newborn engine uses the CDC scenario framework, with the AAP public guide and currently linked algorithm as cross-checks. ACOG supplies the obstetric repeat-screening recommendation. Local resources and surveillance do not change these national rules.
Clinical version 2026.10.18-review.1 · Source check 2026-10-18. Source-check dates are distinct from guideline publication dates. No institutional endorsement or affiliation is asserted.
Scope and interpretation
Automated assessment is limited to infants younger than 30 days. It assigns a guideline pathway and management options, not a binary diagnosis or an individual probability of infection. The engine cannot independently establish maternal stage, interpret neonatal CSF values, or determine reliable follow-up.
- A titer exactly fourfold the maternal titer meets Scenario 1. Later-scenario wording is interpreted using this explicit threshold.
- Age is recorded as completed 24-hour periods. The CDC first-week convention is implemented as q12h before 168 hours and q8h from 168 hours, with the AAP wording difference flagged for clinical review.
- At exactly 24 hours of interrupted therapy, the CDC “more than one day” and AAP “24 hours or more” wording differs. The result explicitly requests reconciliation; interruptions longer than 24 hours require restarting the course under the selected CDC framework.
- Observation eligibility is evaluated separately from the scenario label. Low-titer limits and treatment prerequisites remain source-specific.
- An incomplete evaluation does not itself prove infection; it can make single-dose treatment ineligible.
All operational interpretations, expected cases, and software verification are included in the repository’s clinical release packet. Software review does not replace independent clinical review.
Clinical source registry
- S1 · Congenital Syphilis — STI Treatment Guidelines →CDC · Publication: 2021-07-23 · Revision/reaffirmation: 2021-07-22 · Retrieved: 2026-10-18
Neonatal scenarios 1–4, reverse-sequence situations, Follow-Up, Special Considerations. Primary neonatal framework; S8 still identifies the 2021 treatment guidelines as current.
Verification / interpretation limit: Later-scenario wording conflicts with explicit fourfold examples; see discrepancy register.Evidence category: guideline · Rules: AGE, HIGH, POSSIBLE, LESS, UNLIKELY, REVERSE, ISOLATED, RAPID, FOLLOW, DOSE, INTERRUPT, SPECIAL - S2 · Syphilis During Pregnancy →CDC · Publication: 2021-07-23 · Revision/reaffirmation: 2021-07-22 · Retrieved: 2026-10-18
Diagnostic Considerations, Treatment, Other Management Considerations, Follow-Up. Document maternal stage-appropriate penicillin, weekly intervals, and response without requiring a fourfold fall before delivery.
Verification / interpretation limit: Older risk-based repeat-screening language is distinguished from ACOG universal rescreening.Evidence category: guideline · Rules: MATERNAL, SCREEN, REVERSE - S3 · Congenital Syphilis Evaluation and Treatment Guide →AAP · Publication: not stated · Revision/reaffirmation: not stated · Retrieved: 2026-10-18
Public table adapted from 2024 Red Book Table 3.72. Cross-check for formulation, course, and preferred intravenous option.
Verification / interpretation limit: Exact age-seven and interruption wording differs from CDC; source selection is explicit.Evidence category: guideline · Rules: DOSE, INTERRUPT, LESS, POSSIBLE - S4 · Current linked congenital syphilis algorithm (Figure 3-18) →AAP · Publication: not stated · Revision/reaffirmation: not stated · Retrieved: 2026-10-18
Three-page algorithm; source link verified on S3. Independent cross-check of maternal pathways and titer comparison.
Verification / interpretation limit: Evaluation-incomplete labels differ from CDC; no diagram reproduced.Evidence category: guideline · Rules: HIGH, MATERNAL, POSSIBLE, REVERSE - S5 · CDC Laboratory Recommendations for Syphilis Testing, United States, 2024 →CDC · Publication: 2024-02-08 · Revision/reaffirmation: not stated · Retrieved: 2026-10-18
Serologic testing, endpoint titers, congenital syphilis. Use matching quantitative nontreponemal methods; infant serum; no numeric comparison for unquantified results.
Evidence category: guideline · Rules: LAB - S6 · Screening for Syphilis in Pregnancy →ACOG · Publication: 2024-04 · Revision/reaffirmation: 2025-10 · Retrieved: 2026-10-18
Updated ACOG Recommendation; reaffirmed October 2025. Universal screening at first prenatal visit, third trimester, and birth.
Verification / interpretation limit: Browser retrieval initially failed; later direct official HTML fetch verified title, recommendation and October 2025 reaffirmation; checksum recorded.Evidence category: guideline · Rules: SCREEN - S7 · Syphilis Screening in Pregnancy — physician FAQs →ACOG · Publication: not stated · Revision/reaffirmation: 2025-10 · Retrieved: 2026-10-18
Expert opinion supplement to practice advisory. Supplementary obstetric context; no separate newborn rules derived.
Verification / interpretation limit: Browser retrieval initially failed; later direct official HTML fetch verified title and October 2025 update; checksum recorded.Evidence category: expert-option · Rules: SCREEN, MATERNAL - S8 · Clinical Guidance for STIs →CDC · Publication: 2024-07-31 · Revision/reaffirmation: 2025-07-17 · Retrieved: 2026-10-18
STI Treatment Guidelines; current product notice. Continues to identify 2021 STI treatment guidelines as most current.
Verification / interpretation limit: Page also contains September 2026 product notice; metadata date is not the date of every item.Evidence category: index · Rules: SOURCE - S9 · Annual STI Surveillance →CDC · Publication: 2025-09-24 · Revision/reaffirmation: 2025-09-24 · Retrieved: 2026-10-18
2024 provisional national release and 2023 finalized tables. Surveillance only; no individual risk score or clinical treatment rule.
Verification / interpretation limit: State/national direct comparison uses the same finalized 2023 PDF release; newer provisional national data are separate.Evidence category: index · Rules: - S10 · AtlasPlus →CDC · Publication: not stated · Revision/reaffirmation: 2026-06-22 · Retrieved: 2026-10-18
Official surveillance interface and export reference. Data discovery only; no invented API and no clinical decision use.
Verification / interpretation limit: This build uses official finalized PDF tables rather than a live AtlasPlus query.Evidence category: index · Rules: - S11 · Health Department Directories →CDC · Publication: not stated · Revision/reaffirmation: 2026-06-16 · Retrieved: 2026-10-18
Official department directory. Official resource verification; supplements are documented in DATA.md.
Verification / interpretation limit: Linked accredited department list covers 40 states, so verified official USA.gov/state sites supply complete 51-jurisdiction coverage.Evidence category: index · Rules: - S12 · Latent Syphilis →CDC · Publication: 2021-07-23 · Revision/reaffirmation: 2021-07-22 · Retrieved: 2026-10-18
Treatment; weekly dose intervals. Early latent single 2.4 million-unit benzathine dose; late/unknown duration three weekly 2.4 million-unit doses.
Verification / interpretation limit: Stage requires clinical establishment; not inferred by this engine.Evidence category: guideline · Rules: MATERNAL - S13 · Primary and Secondary Syphilis →CDC · Publication: 2021-07-23 · Revision/reaffirmation: 2021-07-22 · Retrieved: 2026-10-18
Recommended regimen, pregnancy cross-reference. Verifies the early-stage maternal regimen as part of adequacy assessment.
Verification / interpretation limit: Maternal neurosyphilis and nonstandard regimens require specialist adjudication.Evidence category: guideline · Rules: MATERNAL
Surveillance and state resources
Statistics are a versioned, build-time snapshot from CDC annual surveillance (S9); AtlasPlus (S10) is an official exploration resource. State fallback destinations are verified against the CDC health department directory (S11) and USA.gov’s state health directory, with official page verification and explicit retrieval limitations.
Comparisons use the same metric, year, and release. Newer national-only provisional figures are separately labeled. Missing, unavailable, suppressed, and zero are distinct values. The original final 2023 snapshot is not spliced with revised historical rows in the newer provisional release.
Privacy and updates
Rules run locally, with no clinical API or runtime language model. Maintenance checks propose source changes for review; they cannot silently change treatment rules. Clinical changes require a new clinical version and review. Read the privacy explanation.