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At least 919 records · Page 51Linked to original sources
PubMed2004

Prevalence of HIV-1 non-B subtypes, syphilis, HTLV, and hepatitis B and C viruses among immigrant sex workers in Madrid, Spain.

Sexually transmitted disease (STD) remains a major public health challenge in developed countries, exacerbated by the advent of the HIV epidemic. The objectives of this study were to assess the prevalence of serological markers of syphilis, HIV-1/2, HTLV-I/II, HBV, and HCV infections among immigrant sex workers in Madrid, Spain and to characterize the HIV-1 variants in seropositive individuals. Sera from 762 immigrant commercial sex workers (75.3% from sub-Saharan Africa, 18.2% from South America, and 6.4% from Eastern Europe) were collected between 1998 and 2003 in Madrid and examined. Antibody detection was performed by screening assays (RPR, ELISAs) and confirmed by FTA-Abs, LIAs and Western-blot tests. HIV-1 subtyping was carried out by phylogenetic analyses of the protease and envelope genes. Antibodies to HIV-1 were found in 5.2%, while 3.5% tested positive for HBsAg, 3% for syphilis antibodies, 0.8% for HCV antibodies, and 0.2% for HTLV-I antibodies. None were reactive for HIV-2 or HTLV-II antibodies. HIV-1 seroprevalence among Africans and Ecuadorians was 4.5 and 10.9%, respectively. All HIV-1 seropositive Ecuadorians were transsexual men, and 28.6% had active syphilis infection. Up to 80% of HIV-1 positive specimens were characterized as non-B subtypes, with subtypes G, A, and G/A recombinants being the most frequent among African individuals. In contrast, South Americans with HIV-1 infection carried exclusively subtype B variants. A relatively high proportion of immigrant sex workers in Madrid were infected with HIV-1 and syphilis, whereas infections with hepatitis viruses or HTLV were uncommon.

Adult↗
PubMed1975

An introduction to diagnostic criteria of syphilis, treponarid and yaws (treponematoses) in dry bones, and some implications.

Diagnostic criteria of syphilis and some other diseases are proposed from a study of 424 crania and calvariae and 250 long bones in 22 medical museums in Europe. Yaws bone lesions in Uganda and changes in Australian aboriginal bones also contributed to the establishment of these criteria. Any deductions about disease in the past or isolated populations must depend upon acceptable diagnostic criteria; post mortem damage must be recognised. In crania and calvariae the sequence of changes of Virchow's caries sicca, and in long bones nodes/expansions with superficial cavitation are sound indicators of syphilis, and of yaws and treponarid in relevant geographical areas. Attention is called to the cause of sequestra in European calvariae labelled syphilis, the absence of sequestra due to haematogenous pyogenic osteomyelitis in Australian and other aboriginal bones and possibly in Europe before the Middle Ages. The number of bones with diagnostic criteria needed to demonstrate the endemicity of a particular infection in a past community is discussed. There is also need for an extensive application of diagnostic criteria of syphilis to pre-Columbian or pre-European bones everywhere. The uncertain future of old dry diseased bones in medical museums, and the need for reference centres to provide sound advice and guidance in palaeopathology are stressed.

Bone and Bones↗
PubMed1989

Secondary syphilis of the tonsil.

An 18-year-old man with an ulceration of his right tonsil and cervical lymphadenopathy was examined. The patient also had a papular eruption in his face, chest, abdomen, and upper extremities. There were no signs of genital involvement. Routine serological tests for syphilis were reactive and histological findings of a cervical lymph node biopsy were characteristic for syphilitic lymphadenitis. Spirochetes were also identified in the tissue sections. A diagnosis of secondary syphilis of the tonsil with cervical syphilitic lymphadenitis was made. In recent years, the number of new cases of syphilis has increased in Japan. Since the oral cavity is the most common extragenital site of syphilis, clinicians should bear in mind that oral lesions from an unknown cause might possibly be syphilitic.

Adult↗
PubMed1993

Three models to promote syphilis screening and treatment in a high risk population.

Three syphilis control models targeted at a high incidence area were implemented and evaluated over a 31-month period. These models consisted of (1) street-based outreach and referral to community health clinics for free sexually transmitted disease screening and treatment, (2) off-site syphilis screening at high risk locations and referral for free treatment, and (3) off-site syphilis screening and referral at high risk locations with monetary incentives offered for obtaining test results and seeking treatment if required. Off-site screening--conducted at homeless shelters, soup kitchens, drug treatment centers, and community fairs--was found to be significantly more effective in promoting syphilis screening than outreach and referral to community health centers. For the off-site screening models, monetary incentives were related to an increase in the proportion of individuals at homeless shelters and soup kitchens who agreed to be tested, and to an increase in the proportion of people at homeless shelters, soup kitchens and drug treatment centers who sought their test results and obtained treatment, if required.

Adult↗
PubMedDate not supplied

Syphilis evaluation and therapy: a study of current practices in a university hospital.

The incidence of syphilis, after declining for several years, increased by 23% in the first quarter of 1987. The authors reviewed the charts of 100 patients with syphilis in order to determine how such patients were managed in a university setting. Although 77 patients met Centers for Disease Control (CDC) indications for lumbar puncture, only 11 patients had the procedure. Most patients for whom treatment was indicated either were not treated or were treated with inadequate or incorrect medications. Only 30 patients received follow-up serologic tests, and of these, only one received follow-up at the intervals recommended by the CDC. This study indicates that physicians may either be unfamiliar or disagree with the current CDC guidelines for evaluation and management of patients with syphilis. Physicians should know these guidelines and document their reasoning if they choose not to follow them. Long-term follow-up of patients with syphilis is important to ensure effective treatment and to increase understanding of this disease.

Adult↗
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↗
PubMed1995

From mercury to malaria to penicillin: the history of the treatment of syphilis at the Mayo Clinic--1916-1955.

Between 1916 and 1955 the Mayo Clinic became recognized as one of the premier institutions specializing in the treatment of syphilis. First under the direction of John H. Stokes (1916-1924) and later Paul A. O'Leary (1924-1953), its Department of Dermatology and Syphilology, together with the members of the Clinical Cooperative Study Group, oversaw the establishment of standardized methods for the administration of the existing arsenicals and the introduction of new therapies. Malaria therapy, heat therapy, penicillin, and oxytetracycline each represented important advances in the treatment of syphilis and were extensively evaluated. Two important ancillary benefits of syphilis treatment were the development of routine intravenous techniques, which would later prove invaluable for the administration of antibiotics and cancer drugs, and the establishment of large cooperative clinical trials, the first of their kind. Under the leadership of Stokes and O'Leary the department produced a stream of pivotal clinical research that contributed to the effective management of syphilis in the United States.

Arsenicals↗
PubMed1990

History of sexual abuse in incarcerated adolescents with gonorrhea or syphilis.

From July 1983 to June 1984, 2521 adolescents were medically screened at entry into a detention facility in New York City. A medical history, physical examination, serology for syphilis, and culture for gonorrhea were obtained from each entrant. A retrospective chart review was conducted for 136 persons with gonorrhea and/or syphilis (79 boys and 57 girls) and 136 sex-matched infection-negative controls. Several characteristics were compared including age, age at first sexual intercourse, sexual abuse history, contraceptive use, and pregnancy status. Among infected cases, 8% of males and 32% of females reported a history of sexual abuse, whereas among controls, no males and 14% of females reported abuse. A history of sexual abuse was strongly associated with gonorrhea or syphilis (odds ratio = 3.4; 95% confidence intervals, 1.5-8.0). These data suggest an association between sexual abuse and subsequent high-risk sexual behavior manifested by a gonorrhea or syphilis infection.

Adolescent↗
PubMedDate not supplied

Congenital syphilis: old disease, new resurgence.

The resurgence of syphilis has a detrimental effect on the health of communities and populations. As this epidemic continues, pediatric nurse practitioners may care for children with congenital syphilis. Children with congenital syphilis are at increased risk for physical abnormalities and developmental delays. Frequent physical and developmental assessments with goal-oriented plans will assist the child and family to achieve their maximum potential. Pediatric nurse practitioners who are knowledgeable about congenital syphilis, its manifestations, and associated nursing care needs will serve as case managers for children and their families with this diagnosis.

Humans↗
PubMed2006

Analysis of HIV-1 sequences before and after co-infecting syphilis.

Increasing syphilis incidence among men who have sex with men (MSM) has been reported. The index case was a human immunodeficiency virus type 1 (HIV-1)-positive MSM who presented coincidentally with the secondary syphilis and a rebound of plasma viral load after complete suppression of HIV-1 (below 50 copies/ml) for 13 months with potent antiretroviral therapy (PART), suggesting a possibility of HIV-1 superinfection. We analyzed HIV-1 sequences before and after syphilis in four HIV-1-positive patients including the index case to explore drug resistance mutations (DRMs) and a possibility of HIV-1 superinfection. There were patients who obtained DRMs around syphilis infection but no evidence of HIV-1 superinfection was obtained. Our results underline the importance of strict adherence to PART.

Adult↗
PubMed1996

Gastric syphilis: polymerase chain reaction detection of treponemal DNA in pseudolymphomatous lesions.

Syphilis is an unexpected diagnosis in the stomach. To establish the diagnosis, evidence of Treponema pallidum in the gastric lesion is necessary. However, it is sometimes difficult to prove the presence of the organisms by conventional methods. The authors describe two cases of early gastric syphilis with pseudolymphomatous histology in which T pallidum gene was detected by the polymerase chain reaction (PCR) using paraffin biopsy sections. The gastric lesion of each case endoscopically and histologically simulated that of malignant lymphoma. However, no clonality was proved by immunohistochemistry or PCR gene rearrangement analysis. No spirochetal organisms were detected with certainty by Warthin-Starry silver stain, whereas the organisms were shown by immunofluorescent stain in one patient. A PCR study showed the treponemal DNA in both patients, and its validity was supported by a direct sequencing and a restriction enzyme digestion. Positive results of serological tests for syphilis and regression of the lesions after antisyphilitic treatment were confirmatory of the diagnosis. Gastric syphilis should be considered as a differential diagnosis when an atypical lymphoid infiltrate fails to show monoclonality. The present PCR method would be helpful in showing T pallidum using routinely processed small biopsy specimens as the tissue source.

Adult↗
PubMed1999

Different types of antiphospholipid antibodies in AIDS: a comparison with syphilis and the antiphospholipid syndrome.

Alloimmune antiphospholipid antibodies react with phospholipids and are an epiphenomenon of an infectious disease. Most autoimmune antiphospholipid antibodies recognise phospholipid-protein complexes or proteins, such as beta2 glycoprotein I or prothrombin and are related to the clinical features of the antiphospholipid syndrome. Lupus anticoagulant, anticardiolipin antibodies, antiprothrombin, and anti-beta2 glycoprotein I antibodies were studied in 61 human immunodeficiency virus (HIV) patients, 55 syphilis patients, and 45 selected patients with antiphospholipid syndrome. Lupus anticoagulant was present in 72% of HIV and 81% of antiphospholipid syndrome patients. None of the syphilis patients had lupus anticoagulant. Anticardiolipin antibodies were found at comparable prevalence in the three groups (HIV 67%, syphilis 67%, antiphospholipid syndrome 84%). HIV had more frequently anti-beta2 glycoprotein I (13%) and antiprothrombin (12%) antibodies than syphilis (0 and 4%, respectively), but significantly less than antiphospholipid syndrome (61 and 40%, respectively). Autoimmune antiphospholipid antibodies in HIV without clinical features of antiphospholipid syndrome might be a reflex of the immunological chaos and/or the constant antigenic virus stimulus.

Acquired Immunodeficiency Syndrome↗
PubMed1990

The ocular manifestations of syphilis in the human immunodeficiency virus type 1-infected host.

Nine patients with active ocular or optic nerve involvement by syphilis who also had concurrent human immunodeficiency virus type-1 (HIV-1) infection are described. The ocular manifestations of syphilis led to the discovery of HIV-1 seropositivity in four of nine cases. Fifteen eyes were affected. Ocular manifestations were: iridocyclitis in three eyes, vitreitis in one eye, retinitis or neuroretinitis in five eyes, papillitis in two eyes, optic perineuritis in two eyes, and retrobulbar optic neuritis in two eyes. Three patients diagnosed with acquired immune deficiency syndrome (AIDS) had the worst initial visual acuities. Six of nine patients had evidence of concomitant central nervous syndrome (CNS) involvement with syphilis. Benzathine penicillin was administered intramuscularly to three patients. All three had relapses. Seven of nine patients treated intravenously with high-dose penicillin had dramatic responses to therapy with improvement in vision and serologies and no evidence of relapse. Regimens accepted for the treatment of neurosyphilis appear to be adequate for the treatment of ocular syphilis in HIV-1-infected patients though further long-term follow-up will be required.

Adult↗
PubMed1987

Nodular secondary syphilis mimicking cutaneous lymphoreticular process.

We hereby report a case presenting a rare form of secondary syphilis with an unusual nodular eruption accompanied by pruritus and generalized lymphadenopathy, bearing a striking resemblance to lymphoma. The histologic picture was also misleading and was compatible with lymphocytoma cutis. The diagnosis was eventually made after results of serologic tests for syphilis were found to be positive, with an extremely high titer of VDRL, and dark-field microscopy had demonstrated spirochetes in a nodular lesion. Secondary syphilis should thus be considered in the differential diagnosis of nodular lesions resembling lymphoreticular disease. It is also suggested that syphilis be added to the list of diagnoses belonging to the category of pseudolymphoma.

Aged↗
PubMed1997

World War I origins of the syphilis epidemic among 20th century black Americans: a biohistorical analysis.

Syphilis outbreaks and differentials have been an ongoing issue in modern preventive medicine and public health. Since the early 20th Century, a variety of approaches has been employed to explain demographic and temporal variations in the prevalence of syphilis in the U.S. Public health experts and physicians have tended to rely on case-by-case approaches to explain group-specific patterns. This study, however, shows that population-level disease dynamics cannot be ascertained from these individual-level studies. We offer a biohistorical methodology to study syphilis prevalence differentials in U.S. populations. Using historical health data, this study suggests that the social disruption brought on by World War I was the critical and unique environmental condition which ignited an epidemic of syphilis among black Americans. By establishing this beginning point for the epidemic, this study further shows the persistence of the epidemic for the next 40 years and its decline. This biohistorical methodology could be applied to the analysis of STD epidemics in other populations and regions experiencing mass exposure events.

Black or African American↗
PubMedDate not supplied

Gender differences in testing for syphilis in emergency department patients diagnosed with sexually transmitted diseases.

The purpose of this study was to investigate the effect of gender on the likelihood of syphilis screening in Emergency Department (ED) patients with suspected sexually transmitted diseases (STDs). We reviewed charts of patients diagnosed with STDs in an urban university hospital ED from January 1995 through June 1996. Exclusion criteria included documented history of syphilis, syphilitic lesions, return visit within 30 days of the original ED care, and hospital admission. Records for 208 eligible patients were included in the study. Twenty-two of 45 male patients were screened for syphilis as opposed to 12 of 163 female patients (48.9% vs. 7.4%, respectively). This study demonstrates that male patients diagnosed and treated for STDs are more likely to be screened for syphilis than female patients.

Emergency Service, Hospital↗
PubMed1999

Magic bullets need accurate guns--syphilis eradication, elimination, and control.

When cases of early syphilis are treated promptly, the spread of the bacteria within a population is interrupted. However, if complacency is induced by successful control, then upsurges in syphilis incidence can occur. The methods and aims of syphilis control in industrialised countries are reviewed in the light of the potential for regional elimination and global eradication programmes. While the medical means to eliminate syphilis are at hand, acceptable means for finding and treating cases that transmit infection need to be developed, particularly in the marginalized communities with limited access to care.

Communicable Disease Control↗
PubMed2000

Primary syphilis remains a cause of oral ulceration.

After many years the incidence of infective syphilis (infection with Treponema pallidum) is increasing in the United Kingdom. This may reflect changes in sexual attitudes and behaviour, altering trends in HIV disease, and increased foreign travel. Oral disease as a consequence of primary syphilis is rare. The present report details two patients presenting to an oral medicine clinic in London, within a 6-month period in 1999, with oral ulceration as their only clinical manifestation of undiagnosed primary syphilis. The oral aspects of early syphilis and the need for dentists to be aware of changing epidemiological trends in relevant infectious diseases are highlighted.

Adult↗