scholarly journals Rare Case of Four Osseous Lesions of the Skull in a Patient with Secondary Syphilis

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Jace Kusler ◽  
Supha Arthurs

Syphilis is a sexually transmitted infection that is caused by the bacterium Treponema pallidum. Syphilis can present as primary, secondary, tertiary, or congenital. It can have an effect on many different organ systems and tissues leading to a wide variety of symptoms and complications; one rare manifestation is bone involvement. The patient in this case was diagnosed with secondary and early neurosyphilis and was also found to have skull lesions that were due to Treponema pallidum. There are guidelines for the treatment of primary, secondary, tertiary, and congenital syphilis; however, there are currently no guidelines for the treatment of syphilis with bone involvement.

2020 ◽  
Vol 13 (12) ◽  
pp. e235522
Author(s):  
Rajashri Veeresh Patil ◽  
Iain Stephenson ◽  
Cathy J Richards ◽  
Yvette Griffin

Syphilitic proctitis is a rare presentation of sexually transmitted infection that poses a diagnostic challenge as it mimics rectal cancer clinically, radiologically and endoscopically. We report a case of a 66-year-old male patient with a background of HIV infection presenting with obstructive bowel symptoms and initial diagnosis of rectal cancer on CT. Sigmoidoscopy and histopathology were non-diagnostic. A diagnosis of secondary syphilis was suspected after obtaining sexual history and diagnostic serology, avoiding planned surgical intervention.


2018 ◽  
Author(s):  
Mathew A. Beale ◽  
Michael Marks ◽  
Sharon K. Sahi ◽  
Lauren C. Tantalo ◽  
Achyuta V. Nori ◽  
...  

AbstractSyphilis is a sexually transmitted infection caused byTreponema pallidumsubspeciespallidumand may lead to severe complications. Recent years have seen striking increases in syphilis in many countries. Previous analyses have suggested one lineage of syphilis, SS14, may have expanded recently, indicating emergence of a single pandemic azithromycin-resistant cluster. We used direct sequencing ofT. pallidumcombined with phylogenomic analyses to show that both SS14- and Nichols-lineages are simultaneously circulating in clinically relevant populations in multiple countries. We correlate the appearance of genotypic macrolide resistance with multiple independently evolved SS14 sub-lineages and show that genotypically resistant and sensitive sub-lineages are spreading contemporaneously, incompatible with the notion that SS14-lineage expansion is driven purely by macrolide resistance. These findings inform our understanding of the current syphilis epidemic by demonstrating how macrolide resistance evolves inTreponemasubspecies and provide a warning on broader issues of antimicrobial resistance.


Treponema pallidum is the bacterial spirochaete responsible for the sexually transmitted infection syphilis. Syphilis has been recognized as an STI since at least the mid-1500s. Rates declined in the second half of the 20th century, but in the past 20 years have risen >20-fold with >4000 cases per year since 2014. This chapter discusses epidemiology, clinical features of the different stages of syphilis, and management of adults, pregnant women, and children diagnosed with syphilis. The management of complications of syphilis are also explained, including neurosyphilis. Treatment side effects, partner notification, and epidemiological treatment is also covered


1997 ◽  
Vol 8 (12) ◽  
pp. 760-763 ◽  
Author(s):  
S S Wong ◽  
D L T Teo ◽  
R K W Chan

Summary: Seventy-two blood donors who were tested positive by the Singapore Blood Transfusion Service (SBTS) for Treponema pallidum haemagglutination (TPHA) test, were evaluated at the Department of Sexually Transmitted Diseases Clinic (DSC) between November 1994 to December 1996. All underwent syphilis serological testing, including rapid plasma reagin test (RPR), TPHA test and fluorescent treponemal antibody-absorption (FTA-Abs) test. All except one (98.6%) were confirmed TPHA positive by the DSC. Of the 71 TPHA-confirmed-positive donors, 53 (74.6%) were subsequently tested positive for FTA-Abs and 18 (25.4%) were tested negative for FTA-Abs. Twenty-two (31%) of the 71 TPHA-positive blood donors had reactive RPR and 49 (69%) had non-reactive RPR. Of the 22 TPHA-positive donors who had reactive RPR, 19 (86%) had positive FTA-Abs (13 late latent syphilis, 4 serological scar, one late congenital syphilis, one secondary syphilis), and 3 (14%) had negative FTA-Abs (all late latent syphilis). Of the 49 TPHA-positive donors who had non-reactive RPR, 34 (69%) had positive FTA-Abs (24 late latent syphilis, 9 serological scar, one late congenital syphilis) and 15 (31%) had negative FTA-Abs (12 late latent syphilis, 2 serological scar, one false-positive TPHA). Only one TPHA-positive donor referred by the SBTS subsequently turned out to have negative syphilis serology at the DSC. Overall, 68 (95.8%) TPHApositive donors who had a past history of sexual exposure were managed as treated or untreated syphilis, regardless of their RPR or FTA-Abs results. However, FTAAbs was found to be useful in the management of 3 (4.2%) TPHA-positive blood donors in the absence of a history of sexual exposures.


mSphere ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Karen V. Lithgow ◽  
Brigette Church ◽  
Alloysius Gomez ◽  
Emily Tsao ◽  
Simon Houston ◽  
...  

ABSTRACT Treponema pallidum subsp. pallidum is the causative agent of syphilis, a human-specific sexually transmitted infection that causes a multistage disease with diverse clinical manifestations. Treponema pallidum undergoes rapid vascular dissemination to penetrate tissue, placental, and blood-brain barriers and gain access to distant tissue sites. The rapidity and extent of T. pallidum dissemination are well documented, but the molecular mechanisms have yet to be fully elucidated. One protein that has been shown to play a role in treponemal dissemination is Tp0751, a T. pallidum adhesin that interacts with host components found within the vasculature and mediates bacterial adherence to endothelial cells under shear flow conditions. In this study, we further explore the molecular interactions of Tp0751-mediated adhesion to the vascular endothelium. We demonstrate that recombinant Tp0751 adheres to human endothelial cells of macrovascular and microvascular origin, including a cerebral brain microvascular endothelial cell line. Adhesion assays using recombinant Tp0751 N-terminal truncations reveal that endothelial binding is localized to the lipocalin fold-containing domain of the protein. We also confirm this interaction using live T. pallidum and show that spirochete attachment to endothelial monolayers is disrupted by Tp0751-specific antiserum. Further, we identify the 67-kDa laminin receptor (LamR) as an endothelial receptor for Tp0751 using affinity chromatography, coimmunoprecipitation, and plate-based binding methodologies. Notably, LamR has been identified as a receptor for adhesion of other neurotropic invasive bacterial pathogens to brain endothelial cells, including Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae, suggesting the existence of a common mechanism for extravasation of invasive extracellular bacterial pathogens. IMPORTANCE Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subsp. pallidum. The continued incidence of syphilis demonstrates that screening and treatment strategies are not sufficient to curb this infectious disease, and there is currently no vaccine available. Herein we demonstrate that the T. pallidum adhesin Tp0751 interacts with endothelial cells that line the lumen of human blood vessels through the 67-kDa laminin receptor (LamR). Importantly, LamR is also a receptor for meningitis-causing neuroinvasive bacterial pathogens such as Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae. Our findings enhance understanding of the Tp0751 adhesin and present the intriguing possibility that the molecular events of Tp0751-mediated treponemal dissemination may mimic the endothelial interaction strategies of other invasive pathogens.


Author(s):  
Vijayabhaskar Chandran ◽  
Prabahar Periyasamy ◽  
Subramanian Kalaivani

<p class="abstract"><strong>Background:</strong> Syphilis caused by spirochete <em>Treponema pallidum</em> is a bacterial sexually transmitted infection [STI] with protean manifestations. There is a rising trend of this disease due to changing sexual orientation and behavioural practices. The aim was to study the incidence, age, sex distribution, clinical presentation and serological findings of secondary syphilis in patients attending the Institute of Venereology in a tertiary care centre at Chennai.</p><p class="abstract"><strong>Methods:</strong> Retrospective analysis of data of patients diagnosed as secondary syphilis who attended our institute over a period of 2 years from March 2015 and February 2017 was done. Complete epidemiological, clinical and investigational data were analysed.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 57,316 patients who attended the STD clinic 459 patients were diagnosed to have syphilis. Among them 11.6% were found to have secondary syphilis with majority falling within the age group of 21 to 30 years. Among the 53 patients with secondary syphilis 94% were males, among which only 30% were married. Males having sex with males were affected more. Out of the various clinical presentations of secondary syphilis macular leisons was most commonly observed. Serological test done showed VDRL and TPHA positivity in 100% of patients with secondary syphilis.</p><p class="abstract"><strong>Conclusions:</strong> There is increased prevalence of secondary syphilis among the males, especially among young unmarried males with homosexual orientation and promiscuity. Observations of this study emphasize the urgent need for implementation of programs to focus on sex education and counselling to the adolescents and young adults who tends to be the vulnerable population in the society.</p>


2016 ◽  
Vol 43 (7) ◽  
pp. 465-466 ◽  
Author(s):  
Juan Antonio Flores ◽  
Silver Keith Vargas ◽  
Segundo Ramos Leon ◽  
Danny Giancarlo Perez ◽  
Lourdes Beatriz Ramos ◽  
...  

2021 ◽  
Author(s):  
Santa García-Cisneros ◽  
Antonia Herrera-Ortiz ◽  
Maria Olamendi-Portugal ◽  
Miguel A. Sanchez-Aleman

Abstract BackgroundSyphilis is a sexually transmitted infection that is re-emerging in different parts of the world. This infection can be transmitted during pregnancy causing neonatal syphilis. The objective of the study was to determine the trend of syphilis, congenital syphilis, and mortality from congenital syphilis among the Mexican population between the years 2010-2019. MethodsWe formed databases about the incidence of syphilis, the incidence of congenital syphilis, cases of congenital syphilis, and deaths of congenital syphilis using information from the Morbidity and Mortality Yearbooks and the Bulletin of the Mexican Ministry of Health, considering age, sex, the states of Mexico, and year. The trend was analyzed using linear regression, the increase was estimated with 95% confidence intervals, and p<0.05 was considered statistically significant. ResultsThe incidence of syphilis increases on average 0.336 cases/100,000, being higher among women aged 15-19 years (0.693 cases). Congenital syphilis has grown, from 62 cases in the year 2010 to 372 cases in the year 2019; the cases of congenital syphilis have relation to the increase of syphilis among women aged 20-24 years. Fifty percent of the states of Mexico without cases of congenital syphilis in 2010, but only 10% in 2018. Between the years 2010 to 2017, 62 deaths from congenital syphilis were reported. ConclusionCongenital syphilis is increasing in Mexico, as a consequence of the reemergence of syphilis among the population of reproductive age, it is necessary to attend to syphilis in various population groups.


Dermatology ◽  
2019 ◽  
Vol 236 (2) ◽  
pp. 145-150 ◽  
Author(s):  
Xiao Ke Liu ◽  
Jun Li

Background: Secondary syphilis is a sexually transmitted infection, which is referred to as “the great imitator” and has a wide spectrum of clinical manifestations. As a result, it is essential to identify potential secondary syphilis patients with ambiguous clinical manifestation through pathology. Objective: We sought to analyze the pathological features of secondary syphilis. Methods: We analyzed 59 biopsy specimens from 56 patients with secondary syphilis. Cases were classified according to the histological characteristics and clinical features. Results: Necrotic keratinocytes could be observed in 39 of 59 (66.1%) secondary specimens. Plasma cells (86.4%) were the most common finding overall. The presence of Treponema pallidum was detected mostly at the dermal-epidermal junction. There was no statistical significance between pathological features and age, HIV status, or RPR titer. Conclusions: Necrotic keratinocytes are one of the characteristics of secondary syphilis. The combination of plasma cells, irregular acanthosis, elongated rete ridges, and endothelial swelling should increase the likelihood of syphilis.


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