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PubMed1997

Liver involvement in systemic infection.

The liver is heavily involved in the vast majority of systemic infections. Pathophysiological mechanisms involved in hepatic involvement in generalized sepsis require further study, as does the importance of bacterial infection in the presence of cirrhosis. Although parasitic involvement is theoretically dominated by Plasmodium spp., in clinical practice Entamoeba histolytica, Schistosoma spp. and Echinococcus spp. infections are far more important. Hepatobiliary involvement is also a feature of Ascaris lumbricoides, Fasciola hepatica and 'oriental' cholangiohepatitis. Various bacteria (including Mycobacterium tuberculosis, Treponema pallidum and Salmonella spp.) and viruses (e.g., cytomegalovirus, Herpes simplex and dengue) also cause significant hepatic involvement. A high index of suspicion for infection is required in paediatric hepatology.

Bacterial Infections↗
PubMed1997

Prevalence of transmissible blood infections among blood donors at the University of Maiducuri Teaching Hospital, Maiduguri, Nigeria.

Before the advent of the Acquired Immune Deficiency Syndrome (AIDS), many countries of the world transfused blood without seriously considering the potential risks of transmission of infectious agents. Even after it was shown that the Human Immunodeficiency virus(HIV) could be transmitted through blood and blood products, many hospitals and clinics in Nigeria still continue to transfuse unscreened blood. This study was therefore initiated to highlight the risks of transmitting infectious agents through blood transfusion and the category of infectious agents which could be transfused in blood in this area. A total of 364 healthy blood donors were counselled, bled and screened for HIV-1, HIV-2, HBsAg, Treponema pallidum, Plasmodium falciparum and microfilaria. The results show that the three most common infections transmissible through blood transfusion are Hepatitis B(14.9%), HIV-1 (5.8%) and P.falciparum (4.1%). Thirteen of the 364 blood donors (3.6%) and antibodies to T. pallidum. There were no donors with HIV-2 or filarial infection. Infection of donors by hepatitis B virus (HBV), T. pallidum and HIV-1 was not significant dependent on promiscuity, polygamy, previous blood transfusion or local surgery. However, there was a significant difference between donors with no risk factors and those with risk factors with regard to seroprevalence to HBV, T. pallidum and HIV-1 (p = 0.0053). The results confirm that transfusion of unscreened blood carries severe risks of transmitting serious infectious agents and that is a need to enforce laws for transfusing blood in Nigeria. Meanwhile, in the absence of screening facilities, proper counselling of blood donors in order to ascertain their risk behaviour should be used to select donors and reduce this risk.

Adult↗
PubMed1988

Characterization of the major outer membrane antigens of Treponema hyodysenteriae.

Outer membrane extracts of Treponema hyodysenteriae were used to evaluate the antibody responses in immunized or convalescent pigs. Western blot (immunoblot) analysis identified antibodies in sera reactive with 14- to 19-kilodalton (kDa) antigens. Reactivity against these antigens could be removed only by absorption of sera with butanol-water-extracted endotoxin from the homologous strain of T. hyodysenteriae. Treatment of the outer membrane extracts with 0.1 M sodium meta-periodate, but not with proteinase K, abolished reactivity with both outer membrane and endotoxin antigens (14 and 19 kDa). These results indicate that swine vaccinated with the outer membrane extract of T. hyodysenteriae develop antibody responses to outer membrane antigens qualitatively similar to those of swine convalescing from active infection, especially antibodies against low-molecular-mass antigens. The nature of the 14- to 19-kDa antigens appears consistent with that of treponemal endotoxin and lipopolysaccharide.

Animals↗
PubMed1980

Serological studies on possible causes of intra-uterine infections in Thai infants.

Serological tests for toxoplasmosis, rubella, cytomegalovirus (CMV), Herpesvirus hominis (HVH) infections syphilis (TORCHES) were carried out in 49 infants with showed signs of possible intrauterine infections and in 212 mothers and their newborn infants. The tests employed were ELISA for rubella and CMV infections, indirect haemagglutination for HVH infection and toxoplasmosis and RPR Macro-vue card test for syphilis. The immunoglobulin class of the antibody was also determined, and only infants with IgM antibody was considered indicative of intrauterine infection. It was found that 36.7% and 10.2% of infants with signs of intrauterine infections were positive for rubella and CMV antibodies and 19% had mixed infections of rubella, CMV, toxoplasma, syphilis and HVH. In contrast, only 6.1% of normal newborn infants had rubella antibody, 6% had HVH antibody and less than 1% had toxoplasma antibody, and none of them had CMV and treponema antibodies. Higher rate of seropositivities were found in their mothers, the percentage seropositivities for rubella, HVH, CMV infections, syphilis and toxoplasmosis were 19%, 12%, 2% and 1% respectively.

Antibody Formation↗
PubMed1985

Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): experience at UCSF and review of the literature.

In this review of the acquired immunodeficiency syndrome (AIDS), the authors have evaluated a total of 352 homosexual patients with AIDS or generalized lymphadenopathy managed at the University of California, San Francisco (UCSF), between 1979 and 1984. Of an initial unselected group of 318 patients, 124 (39%) were neurologically symptomatic, and one-third already had their neurological complaints at the time of presentation. An additional 210 AIDS patients with neurological symptoms have been reported in the literature. Thus, a total of 366 neurologically symptomatic patients with AIDS or lymphadenopathy are reviewed. Central nervous system (CNS) complications, encountered in 315 patients, included the following viral syndromes: subacute encephalitis (54), atypical aseptic meningitis (21), herpes simplex encephalitis (nine), progressive multifocal leukoencephalopathy (six), viral myelitis (three), and varicella-zoster encephalitis (one). Non-viral infections were caused by Toxoplasma gondii (103), Cryptococcus neoformans (41), Candida albicans (six), Mycobacteria (six), Treponema pallidum (two), coccidioidomycosis (one), Mycobacterium tuberculosis (one), Aspergillus fumigatus (one), and Escherichia coli (one). Neoplasms included primary CNS lymphoma (15), systemic lymphoma with CNS involvement (12), and metastatic Kaposi's sarcoma (three). Cerebrovascular complications were seen in four patients with hemorrhage and five with infarction. Five patients in the UCSF series had multiple intracranial pathologies, including two cases of simultaneous Toxoplasma gondii infections and primary CNS lymphoma, two cases of coexistent Toxoplasma gondii and viral infections, and one case of combined Toxoplasma gondii and atypical mycobacterial infection. Cranial or peripheral nerve complications, seen in 51 patients, included cranial nerve syndromes secondary to chronic inflammatory polyneuropathy (five), lymphoma (five), and Bell's palsy (five). Peripheral nerve syndromes included chronic inflammatory polyneuropathy (12), distal symmetrical neuropathy (13), herpes zoster radiculitis (six), persistent myalgias (two), myopathy (two), and polymyositis (one). In light of the protean behavior of AIDS and the problems related to the clinical, radiological, and serological diagnosis of the unusual and varied associated nervous system diseases, patients with AIDS and neurological complaints require a rigorous and detailed evaluation. The authors' experience suggests that biopsy of all CNS space-occupying lesions should be performed for tissue diagnosis prior to the institution of other therapies.

Acquired Immunodeficiency Syndrome↗
PubMed1969

Automated, quantitative microhemagglutination assay for Treponema pallidum antibodies.

An automated, quantitative microhemagglutination assay for antibodies to Treponema pallidum was developed by using T. pallidum-sensitized erythrocytes and an automatic serial-dilution instrument. Reactivity was found in sera from 54 rabbits and 6 chimpanzees infected with T. pallidum. Reactivity was also found in sera from animals infected with T. pertenue, T. carateum, and T. cuniculi. No reactivity was found in sera from 75 normal rabbits or from 129 rabbits immunized with cultivatable treponemes or a variety of other bacteria. In approximately 3 min, 13 twofold serial dilutions of each of 8 preabsorbed sera and the addition of sensitized erythrocytes to each dilution were accomplished automatically. The automated assay can serve as a research tool in quantitating antibodies to pathogenic treponemes, and evaluation of its clinical usefulness seems warranted.

Absorption↗
PubMed1998

[Progressive sensorineural hearing loss from infectious agents].

The progressive sensorineural hearing loss due to infectious causes can involve different etiological agents like bacteria, viruses, protozoons or mycetes. These infectious agents can act in various ways: directly through a labyrinthitis that may destroy the neuroepithelium; through an ischaemic process secondary to a septic embolus; or through a thrombus. In some cases the damage can occur in a meningitis context, because of the passage of the germ in the inner through the nerves, the vases or the labyrinthine liquids. Bacterial meningitis is one of the causes of progressive sensorinueral hearing loss. Among bacteria, the Mycobacterium Tuberculosis has nowadays acquired a remarkable importance which is also due to its considerable diffusion, despite modern therapy, and to its association with HIV infection. Bacteria can also cause a labyrinthitis acting directly on the inner ear: among these, Treponemas Pallidum, a spirochaete which causes syphilis and Borrelia Burgdorferi, a spirochaete that causes Lyme Disease, must be mentioned. The viruses that are certainly involved in the etiology of progressive sensorineural hearing loss are Cytomegalovirus and Rubella virus. The virus usually causes a labyrinthitis after the viraemia, wich may be due to the passage of the virus from the blood to the endolymph, through the stria vascularis with the consequent infection of the sensorial cells of the organ of Corti. Less frequently the viral damage to the inner ear can occur after a vasculitis, a meningitis or an alteration of the cell-mediated immunity. Progressive sensorineural hearing loss can also occur because of some congenital viral infections such as those caused by Cytomegalovirus and Rubella virus. More recently even the Human Parvovirus B19 seems to have been involved. This virus seems to act through autoimmune and/or immunologic processes, like that causing sudden hearing loss in Lassa fever. Another viral infection which can nowadays more frequently be considered among the cause of progressive hearing loss is HIV. In the HIV infection the neurological toxic lesions due to the administered ototoxic drugs are added up to the damages caused by the opportunistic infectious agents (virus, bacterium, protozoon mycete). However, in these patients HIV itself could be the cause of the auditory and vestibular lesions. More rarely, a progressive hearing loss may be due to the action of a protozoon or mycete only.

Disease Progression↗
PubMed1996

Stillbirths and maternal antibodies to Chlamydia trachomatis. A new EIA test for serology.

OBJECTIVE: The relationship between stillbirths and infections during pregnancy. METHODS: Antibodies to 13 different viruses and to Mycoplasma pneumoniae, Treponema pallidum, Toxoplasma gondii, and Chlamydia trachomatis, psittaci, and pneumoniae were studied from sera of 42 mothers with stillbirth and of matched case-control pregnancies. RESULTS: Elevated antibody levels to Chlamydia trachomatis and human parvovirus B19 were observed in seven mothers with stillbirth as compared with one in matched case controls (p-0.03 and p < 0.06, Fisher's exact one- and two-tailed p values). By a novel EIA test for C. trachomatis, based on synthetic polypeptide, 15 positive cases were detected in patients compared to seven in controls. Placental calcifications and fetal growth retardation appeared more often (p < 0.001 and p < 0.05, respectively) in the C. trachomatis- associated cases than in the others. There was no significant relation between stillbirth and the other antibodies. CONCLUSIONS: We suggest C. trachomatis as a hitherto unrecognized possible cause of still-births besides human parvovirus B19. A new EIA test for C. trachomatis, one covering all strains, is promising and makes the future assays more convenient, and may thus make it possible to reduce the rate of stillbirths.

Adult↗
PubMed1982

Laboratory evidence for impaired cellular immunity in different stages of syphilis.

Abundant evidence suggests that Treponema pallidum (T.p.) escapes humoral immune defence despite the host produces antibodies early in the infection. Since the serologic responses in syphilis have been studied in detail this paper focuses on the cellular immune mechanisms. For this purpose the leukocyte migration inhibition was investigated in 17 patients in different stages of syphilis. Leukocyte migration inhibition assay was performed before, and 7 days, 3 weeks, 2 mo. and 1 yr after start of treatment. Ultrasonicated T.p. were used as antigen corresponding to 5 X 10(6) to 2 X 10(7) Treponema pallida per ml. Controls without antigen, with addition of Concanavalin. A instead of T.p. and using cells of normal volunteers were run. There was no leukocyte migration inhibition before treatment, suggesting nonexistent or depressed cellular immunity in the untreated syphilitic patient. Significant leukocyte migration inhibition, however, was observed as early as 2 days after start of treatment, being most pronounced after 1 week. Hypothetical circulating blocking factors for cellular immune reactions might be present in the untreated syphilitic patient, which become abolished after therapy. Since stimulation with Con A of syphilitic leukocytes gave normal results even before treatment in the syphilitic patient, there might be a specific block of leukocyte migration inhibition against T.p.

Cell Migration Inhibition↗
PubMed2001

Treponema socranskii, Treponema denticola, and Porphyromonas gingivalis are associated with severity of periodontal tissue destruction.

BACKGROUND: The aim of the present study was to identify Treponema socranskii in addition to Treponema denticola and Porphyromonas gingivalis by polymerase chain reaction (PCR), and to clarify the relationship between the presence of these microorganisms and the severity of clinical periodontal parameters. METHODS: Saliva and subgingival plaque collected from 123 subjects (38 aggressive periodontitis patients, 65 chronic periodontitis patients, 20 healthy patients) were subjected to PCR to detect the aforementioned 3 microorganisms. RESULTS: Detection frequencies of T. socranskii, T. denticola, and P. gingivalis in plaque samples from aggressive periodontitis patients (71.1%, 73.7%, 84.2%, respectively) and chronic periodontitis patients (89.2%, 93.8%, 95.3%) were much higher than those from healthy subjects (30%, 5.0%, 10.0%). In aggressive and chronic periodontitis patients, these 3 species of bacteria were detected frequently at sites that showed deep periodontal pockets and severe attachment loss. The percentage of these bacteria-positive sites increased as the gingival index score of chronic periodontitis patients increased. T. socranskii was frequently detected together with T. denticola or P. gingivalis at the same sites, and coexistence of these microorganisms was frequently observed in deep periodontal pockets of aggressive periodontitis patients. CONCLUSIONS: T. socranskii, T. denticola, and P. gingivalis were frequently detected in periodontitis patients by PCR. The prevalence of these 3 microorganisms was correlated with various clinical parameters. Taken together, our findings suggest that T. socranskii, T. denticola, and P. gingivalis are associated with the severity of periodontal tissue destruction.

Adolescent↗
PubMed2002

Biological characterization of lipopolysaccharide from Treponema pectinovorum.

This study investigated the endotoxic and biological properties of purified lipopolysaccharide (LPS) isolated from an oral spirochete, Treponema pectinovorum. Endotoxicity, measured by Limulus amoebocyte lysate kinetic assay, showed that the LPS contained 1.28 endotoxin units per microg of purified LPS, which was approximately 4,000 times less than Escherichia coli O55:B5 LPS. To determine in vivo endotoxicity, LPS responder mice were administered LPS following galactosamine (GalN) sensitization. The LPS induced neither endotoxic symptoms nor lethality for 96 h, suggesting negligible or very low endotoxicity. In contrast, infection with live T. pectinovorum induced 100% lethality within 12 h in GalN-sensitized LPS responder mice, indicating an endotoxin-like property of this treponeme. Heat-killed microorganisms exhibited no lethality in GalN-sensitized mice, suggesting that the endotoxicity was associated with heat-labile components. To determine cytokine and chemokine induction by LPS, human gingival fibroblasts were stimulated and secretion of interleukin 1beta (IL-1beta), granulocyte-macrophage colony-stimulating factor, gamma interferon, IL-6, IL-8, and monocyte chemoattractant protein 1 (MCP-1) was assessed. The purified LPS induced significant amounts of only IL-6, IL-8, and MCP-1, although they were substantially lower than levels after challenge with live T. pectinovorum. After injection of LPS or live or heat-killed T. pectinovorum, serum was collected from mice and analyzed for proinflammatory cytokines IL-1beta, tumor necrosis factor alpha (TNF-alpha), and IL-6. LPS induced only IL-6 consistently. Both live and heat-killed T. pectinovorum induced serum IL-6, which was higher than the level detected following LPS administration. Importantly, live bacteria elicited systemic TNF-alpha and IL-1beta levels similar to those induced by a lethal dose of live E. coli O111. The results indicated that T. pectinovorum LPS has very low or no endotoxicity, although it can elicit low levels of cytokines from host cells. In contrast to the LPS, live T. pectinovorum demonstrated in vivo toxicity, which was associated with serum IL-1beta, TNF-alpha, and IL-6, suggesting an endotoxin-like property of a heat-labile molecule(s) of the spirochete.

Animals↗
PubMed1989

Cloning and characterization of Treponema hyodysenteriae antigens and protection in a CF-1 mouse model by immunization with a cloned endoflagellar antigen.

We cloned genes that code for Treponema hyodysenteriae antigens into Escherichia coli with the purpose of identifying protective antigens for vaccine development. Three different genomic libraries were screened with various antisera reactive with T. hyodysenteriae antigens. The cloned antigens and corresponding native T. hyodysenteriae antigens were analyzed for molecular size, serum reactivity, solubility in sarcosine, and segregation during phase partitioning with the nonionic detergent Triton X-114. The results from these analyses suggested that the gene products were components of either the cytoplasmic membrane, periplasm, or endoflagella of T. hyodysenteriae. The cloned antigens were tested as vaccine candidates in a CF-1 mouse model of T. hyodysenteriae infection and immunity. Intraperitoneal injection of crude E. coli extracts containing cloned antigens did not protect mice from challenge. However, serum from mice injected with a crude extract of an E. coli clone which expressed an endoflagellar antigen killed T. hyodysenteriae in vitro. Partially purified preparations of this cloned endoflagellar antigen protected mice against oral challenge with both the homologous serotype (B204) and a heterologous serotype (B234) of T. hyodysenteriae. These results suggest that the endoflagellar proteins could be used as an effective subunit vaccine against T. hyodysenteriae.

Animals↗
PubMed1992

Characteristics of high-risk adolescent outpatients with treponemal antibody.

This study analyzes variables associated with syphilis infection among adolescents attending a public medical clinic in the District of Columbia. All adolescent clinic patients found to have Treponema pallidum antibody from June 1, 1989 through June 1, 1990 were included in the study. Medical records were reviewed for the following data: age, sex, presence or absence of court jurisdiction over the patient, chief complaint, concurrent infections, and the clinical stage of syphilis. The study population included 52 patients. The results revealed that male patients carry a higher risk of remaining undetected because only one third acknowledged any complaints prior to examination. This cohort study illustrates the predilection of syphilis for the indigent and underserved. Moreover, it highlights that insidious disease in adolescents is often unsuspected and undetected until routine screening tests are performed.

Adolescent↗
PubMed1978

Rapid test for diagnosis of syphilis by means of the surface fixation method using as antigens VDRL and Treponema pallidum (strain Nichols).

An attempt to use the "surface fixation" method for the detection of antigen-antibody reactions with VDRL and Treponema pallidum has given results which corroborate conventional serological findings in patients suspected of being infected with this organism. The test is performed over strips of filter paper in which mixtures of the serum with the antigen are deposited and submitted to a special procedure of staining in order to detect antigen-antibody reactions.

Antigen-Antibody Reactions↗
PubMed2003

Positive and negative bacterial associations involving Dialister pneumosintes in primary endodontic infections.

Dialister pneumosintes is an anaerobic Gram-negative rod that has been recently implicated as a candidate endodontic pathogen. In this study, samples taken from abscessed teeth and infected root canals associated with asymptomatic or symptomatic periradicular lesions were examined for the occurrence of bacterial associations involving D. pneumosintes. DNA was extracted from the samples, and the presence of D. pneumosintes and 16 other bacterial species was determined by means of species-specific nested polymerase chain reaction. Positive and negative associations involving D. pneumosintes were investigated by computing the odds ratio of D. pneumosintes being found in a sample from endodontic infection in co-infection with one of the other target species. The association between the pairs containing D. pneumosintes and the occurrence of pain also was evaluated. D. pneumosintes was always detected in mixed infections with at least two of the other target species. D. pneumosintes was positively associated with Treponema denticola, Porphyromonas endodontalis, Fusobacterium nucleatum, Peptostreptococcus micros, Campylobacter rectus, Prevotella intermedia, T. pectinovorum, and T. vincentii. Negative associations were observed with Bacteroides forsythus, P. gingivalis, and Actinomyces israelii. No pair containing D. pneumosintes was found to be significantly associated with symptomatic cases (p > 0.01). The findings of this study lend considerable support to the notion of D. pneumosintes being an important endodontic pathogen, usually in a mixed infection. Positive associations of this species with other highly prevalent species, such as T. denticola and P. endodontalis, suggest that bacterial synergism can occur and thereby play an important role in the pathogenesis of different forms of periradicular lesions.

Adolescent↗
PubMed2006

Steroid refractory episcleritis as early manifestation of neurosyphilis.

Since the incidence of syphilis is constantly rising in western countries during the last few years the awareness of atypical presentations of this treatable disease is warranted. Especially since early treatment results in complete elimination of Treponema pallidum, thus preventing disabilities and neurological deterioration as a consequence of late stage infection. We describe a case in which a patient with asymptomatic neurosyphilis presented with a history of longstanding episcleritis. The patient was first seen in an outpatient setting, where the resistance of ocular inflammation to steroid treatment led to the uncommon diagnosis. Prolonged antibiotic treatment resulted in a complete solution of all clinical findings and a decrease of specific treponemal antibody titers. This case might serve as an example that with the recent increase in sexual transmitted diseases practitioners might be more often confronted with uncommon presentations of syphilis.

Anti-Bacterial Agents↗
PubMed2001

[Congenital syphilis still exists].

INTRODUCTION: Even today screening for congenital syphilis must be performed and confirmed by appropriate serological tests and bacteriological samples. OBSERVATION: A newborn presented with an apparently materno-fetal or viral fetal disease. It was in fact congenital syphilis. The mother exhibited no risk factors for syphilis. Systematic serological search for syphilis was negative in the mother at 11 weeks of amenorrhea. No signs of primary or secondary syphilis had been observed during pregnancy. At twenty-nine weeks of amenorrhea, the mother presented a menace of preterm delivery and no tocolysis at 31 weeks. Examination of the newborn revealed clinical signs of aterno-fetal infection, without specificorientation. Initial bacteriological and virological analyses were negative. Screening for specific Treponema pallidum M-type immunoglobulines (IgM) on the 9th day of life, confirmed the diagnosis of congenital syphilis. COMMENTS: Diagnosis of congenital syphilis must not be eliminated during early serological screening: clinical suspicion must lead to further anamnesis again and serological tests both in the newborn and the mother.

Humans↗