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PubMed1982

Sexually transmitted diseases. Primary syphilis.

Syphilis is an infectious spirochetal disease caused by Treponema pallidum. The disease is transmitted from person to person during sexual intercourse, congenitally by an infected pregnant woman to the fetus in utero, or very rarely, non-sexually. In its natural course, syphilis is characterized by an acute infectious primary and secondary stage, followed by a subclinical course of latency which may persist for years, or may progress in a minority of patients to a noninfectious late symptomatic stage where active involvement of the central nervous system, the cardiovascular system or localized gummatous destructive lesions may occur. This article reviews the clinical features and management of primary syphilis.

Chancre↗
PubMed1993

[Current aspects in the diagnosis of syphilis].

In order to present the diagnostic possibilities of treponemal infections, syphilis can be chosen as an example. The direct detection of the pathogen is limited mainly to the early stages of the disease. The diagnostic significance of the PCR as a possible alternative method cannot yet be estimated. The concept for the serodiagnosis of syphilis which includes the TPHA assay as a screening test, the FTA-ABS as the confirmatory test, and the detection of T. pallidum specific IgM antibodies and lipoidal antibodies for the estimation of the disease activity has proven to be very successful. Whether the enzyme immunoassays can replace or supplement the conventional methods has yet to be evaluated critically. There is no possibility for a general statement on the symptomatology of syphilis and the pattern of serological reactions in HIV-infected persons, since the immune system function of each individual is of great importance.

HIV Infections↗
PubMed1999

[Stage 3 syphilis of the mouth cavity].

BACKGROUND: Untreated syphilis or lues is a chronic infectious disease. It is caused by treponema pallidum, which is most commonly transmitted by sexual contact and occasionally by blood transfusion or by intrauterine infection. If the disorder is not treated, its clinical course can be chronic, persisting for decades. During this time, a variety of morphological signs occur depending on the stage of the disease. CASE REPORT: We describe a case of tertiary syphilis in the oropharynx with a defect of the soft palate. In a 37-year-old woman, the first symptom was a dryness of the throat followed by a feeling of foreign body in the palate area. The patient had a history of sexual contact with a man who had had syphilis ten years ago, and our initial suspicion was confirmed by a final diagnosis of tertiary syphilis. Signs of primary or secondary syphilis were not observed. RESULTS: In the course of diagnostic procedures both further manifestatons of syphilis and other infectious or malignant causes were excluded. The serological results showed a typical constellation of Treponema and non-Treponema serum reactions. The histopathological examination of an exploratory excision from the soft palate showed granulomatous changes with peripheral participation of plasma cells. We initiated appropriate antibiotic therapy, using clemizole penicillin G over a period of 21 days, which induced healing of the soft palate. CONCLUSIONS: A defect of the soft palate was diagnosed as a very rare sign of tertiary syphilis.

Adult↗
PubMedDate not supplied

Multiple blood-borne and sexually transmitted infections in sexually transmitted disease clinic and hospital emergency room patient populations.

The degree of coinfections with blood-borne or sexually transmitted pathogens (HIV-1, HTLV-I/II, HBV, HCV, HDV, and Treponema pallidum) were assessed in individuals attending sexually transmitted diseases (STD) clinic and patients admitted to a hospital through the emergency room in Baltimore. Enzyme-linked immunosorbent assays (ELISA), immunoblots, and card tests were used to screen the sera. Nearly one third of the individuals in both populations were infected with one or more pathogens. With some minor exceptions, all individuals with dual or multiple infections had antibodies reactive with the HBV core antigen. There was a strong overall association between the presence of antibodies to HIV-1 and the presence of antibodies to HBV core and HCV in both populations. Additionally, the presence of HIV-1 antibodies was significantly associated with the presence of HTLV-I/II antibodies and HBV surface antigen in the STD population and with a positive RPR test result in the H/ER population. We suggest that HIV-1 and/or HTLV-I/II infected individuals in STD clinic and emergency rooms are highly likely to have had past infections with HBV or HCV.

Adolescent↗
PubMed1983

The role of protein component of T. pallidum in inducing skin reaction for delayed hypersensitivity.

The protein component of T. pallidum was shown to be an important agent in inducing the skin reaction for delayed type of hypersensitivity (SDH) in syphilis. Treponema preparations which contained T. pallidum deprived of this component by treating the organisms with merthiolate, formalin or heat, were found unable to produce a distinct positive skin reaction in syphilitic rabbits. Using preparations containing treponemes with preserved protein component, it was possible to induce the skin reaction for DH in rabbits as early as 4 weeks after inoculation of T. pallidum and during the subsequent 64 weeks of the infection (and of the observation period). The SDH was fairly well correlated with the results of the MMI test in the whole course of the syphilitic infection; a disagreement of results of these two tests occurred only between the 16th and 26th week of the infection.

Animals↗
PubMed2004

Herpesviruses, the missing link between gingivitis and periodontitis?

Herpesviruses appear to assume a major etiopathogenic role in various types of destructive periodontal disease. Human cytomegalovirus (HCMV), Epstein-Barr virus (EBV) and HCMV-EBV co-infection are closely associated with disease-active periodontitis in juveniles and adults, with acute necrotizing ulcerative gingivitis in children, and with periodontal abscesses. In particular, HCMV reactivation in periodontitis lesions seems to be linked to advancing disease. HCMV infects periodontal monocytes/macrophages and T-lymphocytes, and EBV infects periodontal B-lymphocytes. Herpesvirus-infected inflammatory cells generate a great variety of pro-inflammatory cytokines and may possess diminished ability to defend against bacterial challenge. Herpesvirus-associated periodontal sites tend to harbor elevated levels of periodontopathic bacteria, including Dialister pneumosintes, Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, Prevotella nigrescens, Treponema denticola, Campylobacter rectus and Actinobacillus actinomycetemcomitans. In summary, the available data suggest that periodontitis occurs more frequently and progresses more rapidly in herpesvirus-infected than in non-infected periodontal sites. An infectious disease model based on herpesvirus-bacteria-host immune response interactions is presented to explain how a gingivitis lesion or a stable periodontal site with increased probing depth may convert into a tissue-destroying periodontitis lesion.

Adolescent↗
PubMed1990

Sexually transmitted diseases in victims of rape.

The risk of acquiring a sexually transmitted disease as a result of rape is not known, in part because it is difficult to ascertain whether infections were present before the assault or acquired during it. To investigate this question, we examined female victims of rape within 72 hours of the assault and again at least one week after the assault. Of the 204 girls and women initially examined within 72 hours of the rape, 88 (43 percent) were found to have at least one sexually transmitted disease. These diseases included infections caused by Neisseria gonorrhoeae (6 percent of those tested), cytomegalovirus (8 percent), Chlamydia trachomatis (10 percent), Trichomonas vaginalis (15 percent), herpes simplex virus (2 percent), Treponema pallidum (1 percent), and the human immunodeficiency virus type 1 (HIV-1; 1 percent) and bacterial vaginosis (34 percent). Among the 109 patients (53 percent) who returned for at least one follow-up visit (excluding those who were found to be infected at the first visit or who were treated prophylactically), the incidence of new disease was as follows: gonorrhea, 4 percent (3 of 71); chlamydial infection, 2 percent (1 of 65); trichomoniasis, 12 percent (10 of 81); and bacterial vaginosis, 19 percent (15 of 77). There were no new infections with herpes simplex virus, cytomegalovirus, Trep. pallidum, or HIV-1, but follow-up serologic testing was performed in only 26 percent of the patients. On the basis of our assumptions that most venereal infections present within 72 hours of a rape were preexisting and that new infections identified 1 to 20 weeks later were acquired during the assault, we conclude that the prevalence of preexisting sexually transmitted diseases is high in victims of rape and that they have a lower but substantial additional risk of acquiring such diseases as a result of the assault.

Adolescent↗
PubMed1992

Treponema pallidum and Helicobacter pylori recovered in a case of chronic active gastritis.

A 49-year-old man complaining of epigastric pain underwent endoscopy, during which thickened stomach folds below the fundus were observed. Microscopic examination of gastric tissue biopsy specimens revealed chronic active gastritis. Dieterle stain revealed overwhelming numbers of "corkscrew-like" spirochetes. These were proved to be consistent with Treponema pallidum. A comprehensive study of the tissue revealed the added presence of Helicobacter pylori. This appears to be the first case report describing the involvement of H. pylori and T. pallidum together in a case of chronic active gastritis.

Chronic Disease↗
PubMed2006

Bacterial vaginosis in women of low socioeconomic status living in slum areas in Chennai, India.

Bacterial vaginosis (BV) is a common cause of vaginitis among women of childbearing age. This study was performed to investigate the prevalence of BV and its association with sexually transmitted infections among 487 women of low socioeconomic status. Blood, vaginal and endocervical swabs were tested for HIV, herpes simplex virus-2 (HSV-2), Treponema pallidum, BV, Chlamydia trachomatis, Neisseria gonorrhoea and Trichomonas vaginalis. Of the women screened for BV, 120 (25, 95% CI 20.8-28.4) were positive and 40 (8.2, 95% CI 5.8-10.6) were intermediate. Bacterial vaginosis was significantly associated with age >25 (P = 0.014) and sexual experience (P = 0.085). Bacterial vaginosis was also related to concurrent infections with T. vaginalis (relative risk (RR) = 6.6, 95% CI 2.8-15.5, P = 0.000) and HSV-2 (RR = 2, 95% CI 1.3-2.9; P = 0.0031). The role of other possible risk factors needs to be explored.

Adolescent↗
PubMed1996

Concomitant human immunodeficiency virus infection and syphilitic meningitis.

Syphilis has once again become a public health issue with the advent of human immunodeficiency virus (HIV) infection. We report a 28-year-old Chinese man with recently acquired HIV infection together with early neurosyphilis. His presentation of acute mononucleosis-like syndrome, lymphadenopathy, aseptic meningitis, positive central nervous syndrome and reactive Venereal Disease Research Laboratory test in his cerebrospinal fluid helped to reach the diagnosis. Paired serum Western blot tests for HIV infection performed 1 month apart revealed either a new appearance or an increasing intensity of bands for p17, p24, p31, gp41, p52, p55, p68, gp120 and gp160 suggesting recently acquired HIV infection. The lymphadenopathy disappeared spontaneously and the neurosyphilis responded well to 14 days of penicillin G therapy. The Western blot pattern, clinical course, laboratory data, and therapeutic response indicated that the acute retroviral syndrome and early central nervous system involvement caused by Treponema pallidum occurred concomitantly.

Adult↗
PubMed1980

[Screening for syphilis: resulted of a study of 25 000 neonates in Lower Saxony (author's transl)].

The Treponema pallidum haemagglutination test (TPHA) was used to demonstrate syphilis antibodies in filter paper-dried whole blood from 25 000 neonates in Lower Saxony. Syphilis antibodies were demonstrated in the blood of 48 children, these positive results being confirmed by further tests. There were 12 recent syphilis infections. It is recommended that determination of syphilis antibodies by the TPHA test be added routine to the tests for congenital metabolic disorders. The large number of positive findings, the almost negligible additional work, as well as the information value for epidemiological studies on syphilitic infections, support this suggestion.

Germany, West↗
PubMed1982

In vitro cultivation of Treponema pallidum: independent confirmation.

In vitro cultivation of the virulent Nichols strain of Treponema pallidum was achieved in a tissue culture system as described by A. H. Fieldsteel, D. L. Cox, and R. A. Moeckli (Infect. Immun. 32:908-915, 1981). In 7 of 8 experiments, 8.9- to 26.2-fold increases in the number of T. pallidum were observed over a 12- to 12-day period of incubation.

Bacteriological Techniques↗
PubMed1978

Uveitis in rabbits with pleural effusion disease. Clinical and histopathological observations.

Pleural effusion disease (PED) is a generalized infection of laboratory rabbits caused by a virus-like agent. The disease was first described in the late sixties as a mortality problem among rabbits used for the propagation of Nichols' pathogenic Treponema pallidum in Scandinavian laboratories using the T. pallidum immobilization (TPI) test for the serological diagnosis of syphilis. The iridocyclitis, described as a manifestation of PED, has been studied in detail in rabbits experimentally infected with the PED agent. All rabbits surviving the acute phase of infection developed a non-pyogenic, non-granulomatous anterior uveitis during the "viraemic" stage of infection. The ocular signs of disease culminated between days 3 and 6 and disappeared within 2 to 3 weeks. No recurrence of uveitis was observed during a 6-months observation period, nor by subsequent subcutaneous re-inoculation of the PED agent. Histologically, the uveal reaction was mild and regressed almost completely within 4 weeks. Discrete choroidal inflammatory foci occurred in some of the re-inoculated rabbits, but without changes in the anterior eye segment. The uveitis of pleural effusion disease in rabbits seems to be caused directly by the virus-like agent. It might possibly serve as a simple and reproducible model in further uveitis research.

Animals↗
PubMed1990

Influence of human immunodeficiency virus infection on treponemal serology, in patients who have been treated for syphilis.

Sera from 20 homosexual men who were infected with the human immunodeficiency virus (HIV) and had been treated previously for syphilis, were examined for cardiolipin and treponemal antibodies by the Venereal Diseases Research Laboratory (VDRL) test, and the Treponema pallidum haemagglutination assay (TPHA) and fluorescent treponemal antibody absorbed test. In only one case was probable reactivation of syphilis, as judged by rising titres in the VDRL test, noted.

Adult↗
PubMed1994

Syphilis serology among transvestite prostitutes attending an HIV unit in Rome, Italy.

Sixty-seven transvestite prostitutes from Latin America (49 from Brazil and 18 from Colombia) who attended an HIV unit located in the inner city of Rome between January 1991 and June 1992 were studied for syphilis markers by means of both the Treponema pallidum haemoagglutination test (TPHA) and a solid phase haemadsorption test for detection of specific IgM (SPHA-IgM) which are typically present in recent infections. All participants reported more than 500 sexual partners in the past year, and 67.1% of them more than 1500 partners (between 5 and 10 partners per working day). The overall prevalence of anti-HIV antibodies in this population was 65.7%. The prevalence of positive TPHA tests in the population studied was 73.1%, while that of positive SPHA-IgM tests was 10.4%. The prevalence of positive TPHA and SPHA-IgM tests was higher among Columbians than among Brazilians (83.3% vs 69.4% and 22.2% vs 6.1%, respectively) and also showed a positive correlation with the duration of their permanence in Italy. The TPHA and SPHA-IgM positivities were significantly higher among subjects older than 29 years. Positive TPHA was also significantly higher in subjects who reported a history of heroin and/or cocaine abuse while positive SPHA-IgM was higher in subjects who did not use condoms or reported irregular use of them than in subjects who regularly used condoms. No overall correlation was evident between TPHA positivity and anti-HIV positivity, while SPHA-IgM positivity was found to be higher among anti-HIV-negative subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1976

Fetal syphilis in the first trimester.

Evidenc of first-trimester fetal syphilis was sought in the products of conception in a therapeutic abortion clinic. During two collection periods of one week, five patients with serologic and clinical data consistent with recent syphilitic infection were identified. Their conceptuses were carefully examined by silver and immunofluorescent stains for the presence of Treponema pallidum. Two of these five conceptuses (9 and 10 weeks' gestation) were found to contain T. pallidum by these methods. The literature supporting the Langhans layer/five months' placental barrier theory is reviewed and discussed in view of these two first-trimester cases.

Abortion, Therapeutic↗
PubMedDate not supplied

[Syphilis as a chronic systemic infection].

During the last STDs'epidemic in Russia (1994 - 2004) over 2.7 min people have been infected with syphilis. At present the structure of syphilis morbidity is characterized by 37% of latent forms, including 1.5% late latency. The increased level of late latency may result from: an ever-growing number of those with asymptomatic syphilis; disorderly and self-dependent usage of antibacterial preparations; spread of the virus chronic infections (herpes, hepatitis B, C) altering the macroorganism immune response; alcohol and drug abuse which decreases the efficacy of specific therapy. In general, chronization of the syphilitic infection may be caused by antigenically inert treponemal cell surface; paucity of outer membrane protein; residence of treponemas within an immunoprotective niche; uncompleted phagocytosis of treponemes with macrophages. Syphilis remains an "infectio magna" and demands thorough attention to all diagnostic and therapeutic procedures on every stage of the disease.

Anti-Bacterial Agents↗
PubMed1994

Bacteriological diagnosis of periodontal disease.

Dental plaque bacteria cause virtually all the forms of inflammatory periodontal disease. Periodontitis is caused by the specific periodontopathic bacteria, which induce destruction of connective tissue attachment and adjacent alveolar bone. Examinations to identify the infections by Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Campylobacter rectus, Bacteroides forsythus, Fusobacterium nucleatum, Eikenella corrodens and Treponema denticola have recently become essential in diagnosis of periodontal disease. Bacterial examination permits (1) identification of the causative bacteria, (2) assessment of disease activity and (3) monitoring of the effective of periodontal treatments. The author describes details of accurate and rapid methods for detecting periodontopathogens. Transmission of periodontopathic bacteria as clarified by bacterial examination is also discussed in this review. The pathogenic potential of specific bacteria varies among patients and periodontally healthy individuals and can be controlled by host defense mechanisms such as immune responses. The roles of immune responses against periodontopathic bacteria in balance shifts of periodontal disease processes are therefore also discussed in this review.

Antibodies, Bacterial↗