Congenital syphilis is syphilis present in utero and at birth, and occurs when a child is born to a mother with syphilis. Untreated early syphilis infections results in a high risk of poor pregnancy outcomes, including saddle nose, lower extremity abnormalities, miscarriages, premature births, stillbirths, or death in neonates. Some infants with congenital syphilis have symptoms at birth, but many develop symptoms later. Babies exposed, in utero, can have deformities, delays in development, or seizures along with many other problems such as rash, fever, hepatosplenomegaly, anemia, and jaundice. Newborns will typically not develop a primary syphilitic chancre, but may present with signs of secondary syphilis. Rarely, the symptoms of syphilis go unseen in infants so that they develop the symptoms of latent syphilis, including damage to their bones, teeth, eyes, ears, and brain. Chromolithograph appeared in "Bramwell, Byrom Atlas of Clinical Medicine", 1896.