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PubMed1997

[Neurosyphilis 12 years after treatment of primary infection in a meanwhile HIV infected patient].

A 33-year-old male HIV-positive patient developed pure right motor hemiplegia due to meningovascular neurosyphilis. 12 years ago he was successfully treated for early syphilis with a single dose of 2.4 million units penicillin G benzathine without subsequent evidence of new infection or disease progression. Repeated HIV tests remained negative until 1993 when the HIV infection was diagnosed. It is well known that Treponema pallidum, the etiologic agent of syphilis, may be detected in the cerebrospinal fluid during early infection. Thus the former recommended regimen of single-dose penicillin G benzathine may not reliably eradicate T. pallidum from the CNS. Residual organisms may serve as a reservoir for relapse and dissemination in an immunocompromised host.

AIDS-Related Opportunistic Infections↗
PubMed2005

Resolution of furcation bone loss after non-surgical root canal treatment: application of a peptidase-detection kit for treatment of type I endoperiodontal lesion.

Here, we report the management of a type I endoperiodontal lesion with furcation bone loss. A 59-year-old female attended our hospital with the chief complaint of mobility of tooth 46 and recurrent gingival swelling around the tooth. She previously received dental treatment from two dentists, but her condition did not improve. The tooth manifested the symptoms of typical periodontitis, such as gingival swelling, tooth mobility, pus discharge from the periodontal pocket and furcation bone loss. The tooth had no caries and the pulp reacted to an electric pulp test. Careful examination of the gingiva revealed traces of dental fistula. X-ray examination via a gutta percha inserted into the fistula revealed that furcation bone loss was associated with the periapical lesion. We diagnosed a type I endoperiodontal lesion, and applied Periocheck, a detection kit for peptidase-producing bacteria, to check for decreases in bacteria in the furcation and root canals. Soon after non-surgical root canal treatment, the condition of tooth 46 improved without periodontal treatment. After confirming a negative score with Periocheck, the root canal was filled. After 3 months, the furcation bone loss was on the way to recovery. These results indicate that proper diagnosis and confirmation of a decrease in root canal bacteria are important for treating endoperiodontal lesions.

Alveolar Bone Loss↗
PubMed1975

Survival of certain pathogenic organisms in swine lagoon effluent.

Six pigs from a closed herd with no evidence or history of salmonellosis or swine dysentery were fed effluent from an anaerobic lagoon on a farm where salmonellosis and swine dysentery were enzootic. Salmonella saint-paul was isolated from the effluent and fromthe feces and certain tissues of the pigs. Clinical signs typical of swine dysentery and enteric shedding of large numbers of spirochetes with the characteristics of Treponema hyodysenteriae were noted in 5 of the 6 pigs.

Animals↗
PubMed1994

Treponematosis and Lyme borreliosis connections: explanation for Tchefuncte disease syndromes?

A convergence of evidence from macroscopic, radiographic and histologic examination indicates that treponemal infection was present in the 16ST1 Tchefuncte Indian burial population, dated 500 B.C. to 300 A.D. Pattern and nature of lesions suggests that chronic infection induced by variants of the spirochete Treponema pallidum, causing endemic syphilis and/or yaws, resulted in third-stage osseous response. It is suggested that Tchefuncte Indians acquired partial immunity to treponemal infection by exposure to a variant of the related spirochete, Borrelia burgdorferi, the causative agent of Lyme disease. Partial immunity would help explain the relatively mild expression of the treponemal disease process in the 16ST1 skeletal population and the apparent absence of venereal syphilis. Presence of the Borrelia burgdorferi spirochete might be linked to a single incidence of juvenile rheumatoid arthritis.

Arthritis, Juvenile↗
PubMed1992

Detection of Treponema pallidum in early syphilis by DNA amplification.

By using experimentally infected rabbits as a model for early syphilis, the applicability of in vitro DNA amplification was explored for detection of Treponema pallidum. It was determined that whole blood in heparin or EDTA (but not serum), lesion exudate, and punch biopsy as well as swabs of lesions are useful specimens for examination by the polymerase chain reaction. Swabs do not require special diluents, and the specimens, whether kept at room temperature or frozen, are well suited for use in the polymerase chain reaction.

Animals↗
PubMed1979

Macrophages in immunity to syphilis: suppressive effect of concurrent infection with Mycobacterium bovis BCG on the development of syphilitic lesions and growth of Treponema pallidum in tuberculin-positive rabbits.

Paired groups of male rabbits were challenged with Treponema pallidum and Mycobacterium bovis BCG. One group had been sensitized to BCG by inoculation 3 weeks before challenge. All animals were challenged intradermally at multiple sites with T. pallidum alone, BCG alone, and both organisms into the same sites. The resulting lesions were followed clinically and histologically. BCG lesions enlarged more rapidly in sensitized rabbits, but they were otherwise no different from those in the controls. T. pallidum lesions enlarged and regressed simultaneously in both groups, but in the BCG-sensitized animals they became twice as large as those in the unsensitized rabbits. Mixed BCG-T. pallidum lesions showed the greatest differences in the two groups of animals. Like the pure BCG lesions, they enlarged more rapidly in the sensitized rabbits but began to recede after 1 week. The corresponding lesions in the controls enlarged more slowly and reached their maximum size after 3 weeks when the receding lesions in the sensitized animals were much smaller. The most marked histological-histochemical difference between the two groups of animals was in the number and activation of macrophages. These cells were more numerous in the mixed lesions of BCG-sensitized animals than in similar lesions of the controls and more activated as determined by beta-galactosidase staining. Although sparsely distributed, activated macrophages were more numerous in the pur T. pallidum lesions of sensitized animals than in those of control animals. Silver-stained sections revealed fewer treponemes in mixed lesions of sensitized animals than in the mixed lesions of control animals. Quantitation of treponemes in pure T. pallidum versus mixed lesions was determined in two groups of rabbits challenged intratesticularly. The total number of treponemes per testis in the mixed lesions of BCG-sensitized rabbits was significantly less than the number in the mixed lesions of control animals, and also less than the number in pure T. pallidum lesions of both groups of animals.

Animals↗
PubMed1984

Transfusion syphilis, survival of Treponema pallidum in donor blood. I. Report of an orientating study.

The influence of storage at 4 degrees C on the survival of Treponema pallidum in donor blood, artificially infected with treponemes of the virulent Nichols strain was studied. Rabbits were inoculated in each testis with 0.5 ml of the blood-treponeme mixture, containing 5 X 10(5) microorganisms/ml, which was stored for up to 336 h. Under these circumstances, the blood-treponeme mixture appeared to be infectious for up to 96 h of storage, based on the demonstration of T. pallidum and serological findings, using FTA-ABS, TPHA and VDRL tests. The two former tests were found to be equally sensitive in detecting incubating syphilis in the rabbits, the VDRL test was significantly slower in this respect. From the absence of orchitis as well as seroconversion in rabbits, inoculated with blood-treponeme mixtures stored for 120 h or longer periods of time, it is concluded that after 120 h of storage infectivity is lost. The presently found survival time of treponemes in blood between 96 and 120 h of storage is discussed in relation with survival times found by other investigators.

Animals↗
PubMed2000

Transcriptional regulation in spirochetes.

Spirochetes belong to a widely diverse family of bacteria. Several species in this family can cause a variety of illnesses including syphilis and Lyme disease. Despite the fact that the complete genome sequence of two species, Borrelia burgdorferi and Treponema pallidum, have been deciphered, much remains to be understood about spirochetal gene regulation. In this review we focus on the environmental transitions that spirochetes undergo during their life cycles and the mechanisms of transcriptional regulation that might possibly mediate spirochetal adaptations to such changes.

Animals↗
PubMed1997

[Late consequences of untreated lyme borreliosis].

The study aimed to evaluate late clinical symptoms and serological changes in persons with erythema migrans (EM) diagnosed 4-11 years ago who were not treated with antibiotics. Among initially included into the study 28 untreated EM cases, twelve persons responded for invitation to the Department. The symptoms and signs which could be related to previous Borrelia burgdorferi infection were present in 9 (75%) untreated patients. They included ischialgia (42%), arthritis (33%) and positive serological tests results (33% of patients, including 2 with clinical signs). These results demonstrate that lack of antibiotic treatment in the early LB stage can result in the development of late disease manifestations.

Adult↗
PubMed1991

Antibody to hepatitis C virus in blood donors found positive for other agents. I. Treponemal infection.

Stored serum samples from 169 blood donors found positive for TPHA were tested for antibodies to hepatitis C virus (anti-HCV) and to hepatitis B core (anti-HBc), as evidence of previous HBV infection, a condition known to be sexually transmissible. Only three donors were positive with a 'first generation' anti-HCV and all three failed to confirm with a recombinant immunoblot assay (RIBA). In contrast, 33 (19.5%) of the TPHA-positive donors were positive for anti-HBc. The results suggest that sexual transmission is not a major factor in the spread of HCV.

Blood Donors↗
PubMed1986

Specific immunoglobulin M and G antibodies in the rapid diagnosis of human treponemal infections.

The serological response to treponemal infections in men before and after specific treatment is analyzed. From the described observations several consequences and possibilities for a specific immunological diagnosis are discussed. In particular, it is shown that early diagnosis of syphilis in need of treatment can be achieved by demonstration of T pallidum-specific IgM antibodies. Finally, new insights into the role of antibody correlations between serum and cerebrospinal fluid are mentioned that have established the detection of asymptomatic neurosyphilis.

Antibodies, Bacterial↗
PubMedDate not supplied

Prospects for development of a treponemal vaccine.

The numbers of people affected by treponemal diseases and the degree of resultant morbidity and mortality emphasize the need for improved methods for controlling these infections. The existence of identifiable infectious stages, the relatively low infectivity rates coupled with long incubation periods, the noninfectious nature of the latent stage, and the lack of a known animal reservoir make treponemal diseases good candidates for control by active immunization. The development of a practical, effective vaccine against the treponematoses is dependent on an understanding of the pathogenesis of the diseases, a knowledge of the immunologic mechanisms of resistance, a definition of the protective antigens, and a readily available source of these antigens. Recent contributions to our knowledge in these areas include the application of state-of-the-art techniques such as Western blotting, radioimmunoprecipitation, gene cloning, and monoclonal antibody production. The scope of potential vaccines, target populations, safety, and efficacy are topics of discussion.

Antibodies, Bacterial↗
PubMed1979

Capacity of virulent Treponema pallidum (Nichols) for deoxyribonucleic acid synthesis.

Treponema pallidum (Nichols) was extracted from infected rabbit tissue, and cell lysates were prepared for monitoring thymidine kinase and deoxyribonucleic acid polymerase activities. No thymidine kinase could be demonstrated in preparations of T. pallidum or the cultivable T. phagedenis biotype Reiter. Significant levels of deoxyribonucleic acid polymerase were detected in both treponemal samples. Interestingly, comparisons of polymerase activity among a spectrum of bacterial genera revealed a direct correlation between enzyme concentrations and estimated generation time. Incorporation of [3H]uridine and [3H]thymidine into macromolecules by intact T. pallidum and the Reiter treponeme was examined. Selective ribonuclease-deoxyribonuclease digestion and cesium chloride gradient banding demonstrated that T. pallidum, independent of the host, and T. phagedenis were capable of synthesizing deoxyribonucleic acid only from the [3H]-uridine precursor.

DNA, Bacterial↗
PubMed2003

Identification of a Treponema pallidum laminin-binding protein.

Host extracellular matrix (ECM) components represent ideal microbial adhesion targets that many pathogens use for colonization of tissues and initiation of infection. This study investigated the interaction of the spirochete Treponema pallidum with the ECM component laminin. To identify candidate laminin-binding adhesins, the T. pallidum genome was analyzed to predict open reading frames that encode putative outer membrane proteins, as these proteins interact directly with host ECM components. Subsequent recombinant expression of these proteins and analysis of their laminin-binding potential identified one protein, Tp0751, that demonstrated specific attachment to laminin. Tp0751 attached to laminin in a dose-dependent, saturable manner but did not attach to the ECM component collagen type I or IV or to the negative control proteins fetuin or bovine serum albumin. Sodium metaperiodate treatment of laminin reduced the Tp0751-laminin interaction in a concentration-dependent manner, suggesting that oligosaccharides play a role in this interaction. In addition, Tp0751-specific antibodies were detected in serum samples collected from both experimental and natural syphilis infections, indicating that Tp0751 is expressed in vivo during the course of infection. Collectively, these experiments identified Tp0751 as a laminin-binding protein that is expressed during infection and may be involved in attachment of T. pallidum to host tissues.

Adhesins, Bacterial↗
PubMed1992

Prevalence of neurosyphilis in human immunodeficiency virus-infected patients with latent syphilis.

PURPOSE: A prospective study was done to determine the prevalence of confirmed neurosyphilis (cerebrospinal fluid [CSF] Venereal Disease Research Laboratory [VDRL]-reactive) in human immunodeficiency virus (HIV)-infected patients with latent syphilis (reactive serum rapid plasma reagin [RPR] and microhemagglutination-Treponema pallidum [MHA-TP]). PATIENTS AND METHODS: All HIV-infected patients seen for their first visit at the Los Angeles County/University of Southern California Medical Center AIDS Clinic from June through December 1990 were screened for latent syphilis. Those with reactive serum RPRs and MHA-TPs who had not received recent (within 6 months) therapy for syphilis were offered diagnostic CSF sampling. RESULTS: A total of 312 patients were screened, of whom 71 (22.8%) had reactive serum RPRs and MHA-TPs. Thirty-three of these patients (47%) had diagnostic CSF sampling (26 refused lumbar puncture or were lost to follow-up; 12 had had recent therapy for syphilis and thus did not have CSF sampling). Among the 33 patients who had CSF sampling, 20 (60.6%) had normal CSF profiles (white blood cell count less than 8/mm3; protein less than 0.60 g/L; glucose greater than 2.8 mmol/L) and nonreactive CSF VDRLs. Ten of the 33 patients (30.3%) had abnormal CSF profiles and nonreactive CSF VDRLs, and three of 33 (9.1%) had reactive CSF VDRLs. CONCLUSIONS: Asymptomatic neurosyphilis was found in 9.1% of our patient population undergoing CSF sampling, giving a 1.0% prevalence of CSF VDRL-reactive neurosyphilis in the population we screened. The abnormal CSF findings may have been due to either nonreactive CSF VDRL neurosyphilis, central nervous system infection with HIV, or infection with some unrecognized agent.

Adult↗
PubMed1981

Venereal spirochetosis of rabbits: description and diagnosis.

Venereal spirochetosis of rabbits was studied in naturally infected rabbits from an enzootically infected colony containing inbred, partially inbred, and mutant bearing rabbits, and in experimentally infected rabbits from a hysterectomy-derived colony. Naturally and experimentally induced genital lesions were similar clinically and histologically. The most common site of lesions in naturally infected rabbits was the vulva or prepuce. Other sites, in descending order of frequency, were anal region, nose, eyelid, and lip. Clinical appearance of lesions varied from erythematous macules or papules to erosions, ulcers, and crusts. Histological examination of lesions confirmed the presence of erosions, ulcers, and crusts and, in addition, revealed acanthosis and infiltration of the dermis by plasma cells and macrophages. Dark field examination of scrapings from lesions was superior to several other methods for detection of Treponema cuniculi in lesions. The rapid plasma reagin test detected more infected rabbits than examination of lesions. The frequency of false positive rapid plasma reagin tests was low. The frequency of false negative reagin tests varied with the stage of disease.

Animals↗
PubMed1989

[In vitro antibiotic sensitivity of several species of oral spirochetes].

Results of a series of "in vitro" antibiotic susceptibility tests on some strains of oral Treponema are presented. Different antimicrobial agents have shown different results and only tetracycline and erythromycin have shown consistent antibacterial properties. Surprisingly penicillin has allowed a latent "in vitro" growth of the tested Treponema. The Authors conclude that, according to the data presented, a revision of the current criteria of the antimicrobial therapy for the oral infections associated with the presence of species of Treponema is needed.

Anti-Bacterial Agents↗