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PubMedDate not supplied

[Syphilis: a STD back to us].

Sexually transmitted diseases (STD) show frequent epidemiological changes. We report a case of secondary syphilis diagnosed in a 32-year old woman during post-partum. The disease, although showing a typical presentation, raises the problem of dating with precision the contamination time. This is of importance for treating the newborn at risk of congenital syphilis. We highlight the constant attention that should be brought to disclose this venereal disease that shows so variable clinical and histological presentations. Syphilis seems on the rise in the Mosan valley and in some cities where prostitution is imported from Eastern Europe and Africa.

Adult↗
PubMed2004

Recent syphilis trends in Belgium and enhancement of STI surveillance systems.

Over the past five years, a series of syphilis outbreaks mainly occurring among gay men have been observed in Europe. One of these outbreaks was reported in the city of Antwerp, Belgium, during the first quarter of 2001. This outbreak is still ongoing in 2004. Furthermore, active syphilis diagnoses reported by the Sentinel Laboratory Network rose by 89% in the country during the fourth quarter of 2003. An increase in Brussels was also observed during the same quarter (+300%; 24 cases reported). Overall, the sentinel network of clinicians reported that 93.4% of patients were male; among them, 79.9% were men having sex with men (MSM). The overall proportion of patients co-infected with HIV was 50.5% (MSM: 58.6%; male heterosexuals: 23.8%; females: 8.3%); 76.1% of co-infected patients were already aware of their HIV infection at the time they were diagnosed with syphilis.

Adolescent↗
PubMed2005

Did Adolf Hitler have syphilis?

The evidence that Adolf Hitler might have suffered from incapacitating syphilis is reviewed. Rumors that he acquired syphilis from a prostitute at the age of 20 years, with possible re-infection during World War I, can no longer be verified. Evidence is that he was sexually rather inactive throughout his life. Suggestions that Hitler's cardiac lesion and complaints such as transitory blindness, tremor of his left arm and leg, recurring abdominal pain and a skin lesion of the leg were of syphilitic aetiology cannot be supported. Hitler's progressive mental and physical deterioration after 1942, his growing paranoia, fits of rage, grandiosity and symptoms of possible dementia would fit in neurosyphilis. There are, however, also other explanations for his terminal syndrome, and evidence that repeated clinical examinations did not show the characteristic signs of dementia paralytica or tabes dorsalis, swings the balance of probability away from tertiary syphilis.

Famous Persons↗
PubMed1992

[Prevalence of human immunodeficiency virus infection, hepatitis B virus and syphilis in full term pregnancy].

BACKGROUND: The estimation of the frequency of infection by HIV, hepatitis B virus and syphilis in unselected populations of full-term pregnancy is useful for epidemiologic surveillance of these diseases and for decision marking in prenatal detection. METHODS: A transversal study of 3,193 women who gave birth in the Hospital General de Elche between March 1989 and February 1990 was carried out. A blind survey was developed to avoid ethic problems and bias derived from the undertaking of HIV test without patient consent. RESULTS: The prevalence of HIV was 0.5/1,000 women (CI 95%, 0-1.5); HBV 8.9/1,000 (CI 95%, 4.6-13.2) and syphilis 1.5/1,000 (CI 95%, 0.9-2.1). CONCLUSIONS: The diffusion of the AIDS epidemic in Spain to the general population does not at present seems important although studies should be performed in the future to monitor the trend. The prevalence of syphilis in Spain is low in this study in comparison with the results of other Spanish studies which may be explained by greater quality of care in to pregnancy. The prevalence of HBV suggests the need for detection and vaccination of newborns.

Acquired Immunodeficiency Syndrome↗
PubMed2006

[Issues of congenital syphilis in the past twenty years. I. Etiology, epidemiology and diagnosis].

Since 1990 there is an upward trend in the incidence of both acquired and congenital syphilis in the Czech Republic. A similar situation exists in other European countries as well. Higher incidence of syphilis is clearly associated with urban agglomerates and sexual tourism destinations. The only way to reduce the number of cases is a consistent application of mandatory preventive and diagnostic measures. These important measures against the spreading of the infection include mandatory serological testing of pregnant women and newborns (from umbilical blood), antibiotic treatment and systematic follow-up of HIV-positive mothers and children. This paper describes the current epidemiological situation of syphilis in the Czech Republic and presents a review of available diagnostic tests and their significance for diagnosis.

Czech Republic↗
PubMed2006

[Fever and exanthema as manifestations of the second stage of syphilis].

A man aged 30 had been suffering from episodes of fever for several weeks. He had diarrhoea and had developed generalized maculopapular exanthema that also affected the palms of his hands and soles of his feet. After viral causes were excluded the symptoms proved to be caused by syphilis. His condition was complicated by uveitis. The patient recovered after a single dose of benzyl penicillin and local mydratics and corticosteroid eye drops. The incidence of syphilis is rising and its clinical spectrum is broad. Therefore in patients with fever and exanthema of unknown origin this disease should be considered. One should be aware of the wide variety of complications that can result from syphilis.

Adult↗
PubMed2006

Syphilis: still with us, so watch out!

The number of syphilis cases has been increasing in the UK, partly because of localised outbreaks. The sharpest rises have been among men having sex with men, but the incidence among heterosexuals has also risen. Blood-test screening for syphilis is an important part of sexual health, and includes routine screening of pregnant women at the first antenatal visit. Prompt treatment with penicillin in the earlier stages can stop the progression of the disease. Unfortunately, public awareness of syphilis and its potentially serious consequences is low. It is important for health professionals to be alert for signs of the disease and to initiate tests if there is a likelihood that a patient has or is at risk for the disease.

Adult↗
PubMed2006

Prevalence of HIV and syphilis in pregnant women in Leon, Nicaragua.

The objective of this study was to determine the prevalence of HIV and syphilis and to identify risk factors among pregnant women visiting antenatal clinics in León, Nicaragua. During February to April 2004, blood samples from pregnant women were collected after written consent had been obtained. The samples were tested for antibodies against HIV and Treponema pallidum. A questionnaire was also completed. In total, 1,059 women were included. Antibodies against HIV were not detected in any of the women, whereas antibodies against T. pallidum were detected in 16 (1.5%). Risk factors for syphilis included illiteracy, lower education, and two or more pregnancies. HIV does not seem to be highly prevalent among pregnant women in León (prevalence, 0%; 95% CI, 0.0-0.3). The higher proportion of women infected with syphilis than found in earlier studies suggests that sexually transmitted diseases are circulating in the general population and highlights the increasing importance of HIV prevention.

Adolescent↗
PubMedDate not supplied

Exuberant ulcerated lesions of secondary syphilis on the palms--an unusual presentation.

Ulcerated lesions in secondary syphilis are rare. Exuberant tissue is seen in condylomas of syphilis, which occur in flexural and occluded areas of the body and not in open areas such as palms. We report a case of secondary syphilis that presented with ulcerated exuberant lesions on palms, which on initial examination gave an impression of lesions of Orf and Milker's Nodule.

Adult↗
PubMedDate not supplied

Syphilis serology testing: a comparative study of Abbot Determine, Rapid Plasma Reagin (RPR) card test and Venereal Disease Research Laboratory (VDRL) methods.

Blood from 2100 women attending the antenatal clinic of the Port Moresby General Hospital (PMGH) and the 9 Mile urban clinic of Port Moresby was tested for syphili using the laboratory-based Venereal Disease Research Laboratory (VDRL) syphilis serology test and two clinic-based syphilis tests, Abbot Determine and Abbot Syfacard-RR (Rapid Plasma Reagin (RPR) card test). The Abbot Determine and the Syfacard-R tests were compared with the VDRL test, the gold standard in this study. The validation test results of Determine versus VDRL were as follows: sensitivity 92.0%; specificity 94.6%; the predictive value of a positive test 42.6%; and the predictive value of a negative test 99.6%. The validation tests for RPR versus VDRL were as follows: sensitivity 56.3% specificity 96.5%; predictive value of a positive test 41.2%; and the predictive value of a negative test 98.1%. The RPR test costs 3.5 kina (about one US dollar) a test, the VDRL less than 1 kina a test whilst the Determine test kit costs about 5 kina a test. When laboratory time, salaries and other supplies are costed the Determine test is expected to cost relatively much less. Our recommendation is that the Determine test be made available in areas of the country where VDRL is unavailable or where logistics do not allow for test results to be available early enough to make a difference to the care of th pregnant woman and her fetus.

Evaluation Studies as Topic↗
PubMed1990

Noduloulcerative or "malignant" syphilis occurring in an otherwise healthy woman: report and review of a dramatic dermatosis.

We present the case of an otherwise healthy woman with noduloulcerative ("malignant") syphilis, the first female patient reported with this dermatosis in fifty years. This rare form of secondary syphilis is characterized by noduloulcerative lesions with rupioid crusts that dramatically involve the face while usually sparing the palms and soles. The aggression and destruction of the skin lesions may mimic that of other granulomatous and infiltrative dermatoses. Since the incidence of syphilis is increasing, physicians should be aware of this variant that is so disfiguring it has historically been referred to as lues maligna.

Facial Dermatoses↗
PubMed1990

[Early syphilis and the skeletal system].

Eleven patients with early syphilis were selected at the University Dermatology Clinik in Frankfurt/M, and bone scintigraphy was performed to check for bone lesions as sign of a systemic character of the disease. The 99mTc-methylene diphosphonate scintigrams were compared with those in a control group of 50 patients. Focal hot spots indicating early metabolic changes in bone were found in all 11 patients with early syphilis. The difference between the two groups was statistically significant. The most frequent sites of hot spots were the joints of the palmar and plantar first digits. Foci were also found at the tibial tuberosities. The results support the hypothesis that reactive focal osteitis is caused by penetrating treponemes in the very early stages of syphilis. Also, we can confirm the high sensitivity of bone scintigraphy for the early detection of metabolic changes in bone compared with conventional X-ray images.

Adult↗
PubMed1987

Hair root studies in patients suffering from primary and secondary syphilis.

The hair root status (trichogram) was studied in eleven patients with primary and eight with secondary syphilis. Variables studied in addition to the hair roots were absence or presence of hair root sheaths, deformities and hair roots with angulations exceeding 20 degrees. A decrease in the number of anagen hair roots and an increase in the number of catagen hair roots, dysplastic/dystrophic roots and anagen hair roots with sheaths and more than 20 degrees angulation was observed in both groups of patients. No difference was demonstrable between the findings in primary and those in secondary syphilis. Whether the abnormalities found in the trichogram are specific of syphilis, is unknown.

Adolescent↗
PubMed1989

Autoimmune antibodies and pregnancy outcome in women with false-positive syphilis test results. A retrospective controlled investigation of women from 5170 deliveries.

Nine pregnant women with false-positive syphilis test results, and 13 matched controls, were screened for autoimmune antibodies to ascertain whether any relationship might exist between their presence and the occurrence of obstetric problems. Investigations included assays for anti-cardiolipin antibodies (ACA), lupus anticoagulant (LAC), anti-nuclear antibodies (ANA) (including antibodies against extractable nuclear antigen), anti-smooth muscle antibodies, anti-mitochondrial antibodies, anti-DNA antibodies, IgM-RF and complement factors. We found no significant difference in the incidence of obstetric problems between the two groups. Except that significantly more women were positive for ACA in the group with false-positive syphilis tests than in the control group, there were no differences between the groups with regard to the antibodies tested for. There was only one case of SLE, a patient positive for LAC, and who had had several miscarriages and no pregnancy resulting in a live birth. Our findings suggest that it would be unwarranted to devote resources to routine screening for these antibodies in healthy women with a false-positive syphilis test result, though the presence of LAC could possibly be used as an indicator of the risk of spontaneous abortion due to SLE.

Antiphospholipid Syndrome↗
PubMed1989

Panuveitis with positive serological tests for syphilis and Lyme disease.

The Treponema pallidum hemagglutination test and the fluorescent treponemal antigen absorption test are commonly considered highly specific serologic tests for syphilis. We describe a patient with panuveitis and a positive serologic result for syphilis; however, in the absence of clinical findings, additional tests for Lyme disease (borreliosis) were positive as well, although by Western blot test the diagnosis was tentative. The clinical appearance of the panuveitis was similar to that of syphilitic uveitis accompanied by pseudopigmentosa-like areas in the anterior retina. In the presence of uveitis with an otherwise unexplained positive serologic result for syphilis, the differential diagnosis of Lyme disease should be considered.

Diagnosis, Differential↗
PubMed1989

Routine screening for syphilis is justified in patients admitted to psychiatric, alcohol, and drug rehabilitation wards of the Veterans Administration Medical Center.

Of 1515 patients admitted to psychiatric, alcohol, and drug rehabilitation services in the Veterans Administration Medical Center, Buffalo, NY, during the year 1987, who were screened by serologic tests for syphilis, 16 (1.05%) had positive rapid plasma reagin and fluorescent treponemal antibody-absorption tests for syphilis. A positive serologic test result was not suspected on clinical grounds in any of these patients. All were detected by routine screening. Of the 16 patients, 15 had charts available for review. Seven patients were treated for primary or late syphilis; four patients had received previous treatment; and four patients had no evaluation of test results and received no treatment. Routine screening of hospitalized patients who are alcohol or drug abusers is justified, but close follow-up is necessary to make screening meaningful.

Adult↗
PubMed1989

Extensive nodular secondary syphilis.

An indigent male patient presented with a widespread nodular eruption involving the torso and limbs. The differential diagnosis included nodular secondary syphilis, Kaposi's sarcoma, sarcoidosis, and lymphoma. Investigation confirmed secondary syphilis with positive cerebrospinal fluid serologic findings. Penicillin therapy produced a Jarisch-Herxheimer reaction despite pretreatment to diminish this. Discussion on the clinical features and treatment of syphilis is presented.

Adult↗
PubMed1989

Epidemiology of congenital syphilis.

Between 1984 and 1987, the number of reported cases of congenital syphilis in New Jersey tripled. Findings indicate an increase in early syphilis among females of childbearing age living in areas of high syphilis morbidity, reflecting, possibly, lifestyle changes within populations already at risk for the disease. Future studies and interventions are needed.

Adult↗