P328 HIV status is not associated with Treponema pallidum burden in early syphilis cases in Cali, Colombia

ABSTRACT Doxycycline is regarded as an effective therapy for early syphilis, and there is increasing interest in using doxycycline for prophylaxis of this infection. However, the MIC of doxycycline for Treponema pallidum subsp. pallidum has not been reported previously. In this study, an in vitro culture system was utilized to determine that the MIC of doxycycline is 0.06 to 0.10 μg/ml for four strains of T. pallidum subsp. pallidum (Nichols, SS14, UW231B, and UW249B). The Nichols strain cultured in vitro with doxycycline was also tested for infectivity in rabbits, and the minimum bactericidal concentration (MBC) was found to be ≤0.1 μg/ml using this method. The low MIC and MBC values are consistent with the previously demonstrated clinical efficacy of doxycycline for the treatment of early syphilis. This study represents the first report of the in vitro susceptibility of T. pallidum to doxycycline, and the resulting information may be useful in the consideration of doxycycline for use in prevention of syphilis.

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Comparison of Methods for the Detection of Treponema pallidum in Lesions of Early Syphilis

Sexually Transmitted Diseases ◽

10.1097/00007435-199609000-00004 ◽

1996 ◽

Vol 23 (5) ◽

pp. 366-369 ◽

Cited By ~ 22

Author(s):

MARINELLA C. CUMMINGS ◽

SHEILA A. LUKEHART ◽

CHRISTINA MARRA ◽

BARRY L. SMITH ◽

JEANNE SHAFFER ◽

...

Keyword(s):

Treponema Pallidum ◽

Comparison Of Methods ◽

Early Syphilis

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Unexpectedly high prevalence of Treponema pallidum infection in the oral cavity of human immunodeficiency virus-infected patients with early syphilis who had engaged in unprotected sex practices

Clinical Microbiology and Infection ◽

10.1016/j.cmi.2015.04.018 ◽

2015 ◽

Vol 21 (8) ◽

pp. 787.e1-787.e7 ◽

Cited By ~ 12

Author(s):

C.-J. Yang ◽

S.-Y. Chang ◽

B.-R. Wu ◽

S.-P. Yang ◽

W.-C. Liu ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Oral Cavity ◽

Treponema Pallidum ◽

Unprotected Sex ◽

Early Syphilis ◽

Immunodeficiency Virus ◽

High Prevalence ◽

Sex Practices

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Secondary syphilis presenting as erythema multiforme in a HIV-positive homosexual man: a case report and literature review

International Journal of STD & AIDS ◽

10.1177/0956462418805197 ◽

2018 ◽

Vol 30 (3) ◽

pp. 304-309

Author(s):

Hongfang Liu ◽

Beng-Tin Goh ◽

Taoyuan Huang ◽

Yinghui Liu ◽

Ruzeng Xue ◽

...

Keyword(s):

Plasma Cell ◽

Erythema Multiforme ◽

Treponema Pallidum ◽

Inflammatory Cells ◽

Secondary Syphilis ◽

Penicillin G ◽

Cell Infiltrate ◽

Early Syphilis ◽

Skin Histology ◽

Anal Warts

Early syphilis can rarely cause erythema multiforme-type eruptions as well as triggering erythema multiforme (EM). EM-like lesions in secondary syphilis are characterized by clinical features of EM and laboratory tests consistent with secondary syphilis and the skin histology shows predominantly a plasma cell infiltrate with the presence of treponemes. When EM is triggered by early syphilis, the skin histology shows mixed inflammatory cells usually in the absence of treponemes in the skin lesion. There may also be mixed histology with the presence of treponemes in the absence of a plasma cell infiltrate and vice versa. We describe a case of secondary syphilis presenting as EM with bullae and histology showing EM features without a plasma cell infiltrate but positive for Treponema pallidum by immunohistochemical staining. The patient was also coinfected with cytomegalovirus, human immunodeficiency virus, and anal warts. The EM eruptions resolved with treatment for secondary syphilis with benzathine penicillin G.

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Spirochetemia due to Treponema pallidum using polymerase-chain-reaction assays in patients with early syphilis: prevalence, associated factors and treatment response

Clinical Microbiology and Infection ◽

10.1111/1469-0691.12504 ◽

2014 ◽

Vol 20 (8) ◽

pp. O524-O527 ◽

Cited By ~ 9

Author(s):

B.-R. Wu ◽

M.-S. Tsai ◽

C.-J. Yang ◽

H.-Y. Sun ◽

W.-C. Liu ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Treatment Response ◽

Associated Factors ◽

Treponema Pallidum ◽

Chain Reaction ◽

Early Syphilis ◽

Polymerase Chain

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Clinical Manifestations of Early Syphilis by HIV Status and Gender

Sexually Transmitted Diseases ◽

10.1097/00007435-200103000-00007 ◽

2001 ◽

Vol 28 (3) ◽

pp. 158-165 ◽

Cited By ~ 133

Author(s):

ANNE M. ROMPALO ◽

M. RIDUAN JOESOEF ◽

JUDITH A. O???DONNELL ◽

MICHAEL AUGENBRAUN ◽

WILLIAM BRADY ◽

...

Keyword(s):

Clinical Manifestations ◽

Hiv Status ◽

Early Syphilis ◽

And Gender

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Non-classical pathogens as causative agents of proctitis in men who have sex with men

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab137 ◽

2021 ◽

Author(s):

Eric P F Chow ◽

Darren Lee ◽

Stephanie Bond ◽

Christopher K Fairley ◽

Kate Maddaford ◽

...

Keyword(s):

Comparison Group ◽

Health Centre ◽

Treponema Pallidum ◽

Mycoplasma Genitalium ◽

Risk Difference ◽

Hiv Status ◽

Shigella Spp ◽

Causative Agents ◽

Sex With Men ◽

Asymptomatic Men

Abstract Background This study aimed to identify enteric and sexually acquired rectal pathogens, other than chlamydia and gonorrhoea, associated with symptomatic proctitis in MSM. Methods Anorectal swab samples were obtained from MSM presenting with rectal symptoms and a clinical diagnosis of proctitis at the Melbourne Sexual Health Centre between January-2017 and March-2019. Samples that tested positive for Neisseria gonorrhoeae and Chlamydia trachomatis were excluded. As a comparison group, anorectal samples were also obtained from MSM not reporting symptoms of proctitis between November-2018 and February-2019. Samples from both groups were tested for 15 viral, bacterial and protozoal enteric pathogens using PCR. Results Anorectal samples from 499 men with symptomatic proctitis and 506 asymptomatic men were analysed. Age, HIV status and PrEP use did not differ between men with proctitis and asymptomatic men. Treponema pallidum was more common in men with proctitis (risk difference [RD]=3.6%; 95% CI:2.0-5.2%). Most men with anorectal T. pallidum presented with painful anal primary infections. Shigella spp. was more common among men with proctitis compared to asymptomatic men (RD=1.8%; 95%CI:0.1-3.5%). Most men with Shigella did not report diarrhoea. Mycoplasma genitalium was more common in men with proctitis (RD=4.3%; 95%CI:1.1-7.5%). HSV-1 (RD=10.1%; 95%CI:6.8-13.3%) and HSV-2 (RD=7.2%; 95%CI:4.5-10.0%) were more common with proctitis. Conclusions Testing for T. pallidum, Shigella and HSV should be considered in MSM presenting with symptomatic proctitis. These data provide support for M. genitalium as a significant cause of proctitis. A comprehensive diagnostic evaluation is required for MSM with proctitis.

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