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Molecular differentiation of Treponema pallidum subspecies.

Treponema pallidum includes three subspecies of antigenically highly related treponemes. These organisms cause clinically distinct diseases and cannot be distinguished by any existing test. In this report, genetic signatures are identified in two tpr genes which, in combination with the previously published signature in the 5' flanking region of the tpp15 gene, can differentiate the T. pallidum subspecies, as well as a simian treponeme.

Animals↗

Treponemal serology on Bali Island, Indonesia.

As part of a multidisciplinary study of the population of Bali, Indonesia, treponemal serology was carried out on 2452 serum samples from subjects of both sexes. Sera reactive to the Treponema pallidum immobilisation test (TPI) were found in 81 (3.3%) subjects with a male prevalence of 4% and a female prevalence of 2%. All the reactive sera were from villagers. Of 1118 students sampled in various towns, none had reactive TPI tests. The prevalence of reactive sera varied greatly from one village to another; up to 50% of the sera examined were reactive. Geographical and socioeconomic analyses of the data show a strict correlation between poor socioeconomic status and high reactivity rates to the TPI test. Fifty-seven per cent of all the reactive sera originated from subjects living in two districts where yaws had recently been reported. Only three of the 1406 subjects, aged 15-29 years, had reactive sera. The reactivity rate steadily increased in the age groups 30-44, 45-59, and 60 years and over. Biological false-positive reactions occurred in 3.8% of the sera tested.

Adolescent↗

Gastric syphilis: radiologic findings.

Syphilis, a venereal infection caused by the spirochetal bacterium Treponema pallidum, has long been considered a primary public health concern in the United States. With the onset of the antibiotic era, the prevalence of the disease dramatically plummeted, as did interest in its radiologic manifestations. Rolfs and Nakashima [1] have shown that the prevalence of primary and secondary syphilis increased 34% from 1981 to 1989, to its highest level since 1949. Given this dramatic increase, classic manifestations of syphilis may warrant renewed attention. In its secondary and tertiary stages, syphilis can cause a wide range of gastric lesions that can mimic many other entities, from gastritis or benign ulcer disease to gastric carcinoma. Indeed, the acute gastritis of early secondary syphilis produces the earliest radiologically detectable signs of the disease. Cases of gastric syphilis submitted to the Armed Forces Institute of Pathology and cases drawn from the University of Cincinnati teaching file are used to illustrate the varied findings in this disease.

Diagnosis, Differential↗