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PubMedDate not supplied

[The course of early syphilis in morphine base-dependent rabbits].

Eleven rabbits made dependent on morphine base were observed which were infected with syphilis studying the clinical and serological course of the infection. The control group comprised five non-dependent rabbits infected with syphilis. After 30 days from the infection all animals were given procaine penicillin in daily doses of 75,000 mu/kg. The treatment was carried on for 20 days. In all animals the following serological tests: VDRL, IgG, FTA, TPHA, and TPI were done before the treatment and 1, 3, 6, and 12 months after it. Ulcerations at the site of injection of Nichols strain of spirochetae in all morphinedependent rabbits developed earlier (5-6 days after infection) than in controls (9-10 days), were much larger and persisted longer, while the antibody titres were lower, as a rule, in the morphine-dependent animals. The results presented justify the conclusion that the clinical and serological course of the early stages of syphilis is different in the morphine-dependent animals when compared with controls.

Animals↗
PubMed1989

Eradication of endemic syphilis in Bosnia.

The control of syphilis in Bosnia was organised and started by Professor Ernest Grin in 1948 and continued to the end of 1951. Regardless of the clinical picture, the treatment of endemic syphilis consisted of an oil suspension of penicillin with aluminium monostearate (PAM) 3.6 to 4.2 MIU for adults in six or seven intramuscular injections of 0.6 MIU every day or 1.2 MIU every other day. Today endemic syphilis in Yugoslavia is only historic fact.

History, 20th Century↗
PubMedDate not supplied

Congenital syphilis and necrotizing funisitis.

During the past 5 years we encountered 16 cases of necrotizing funisitis, a deeply seated inflammatory process within the matrix of the umbilical cord, and established that all of them were associated with maternal and congenital syphilis. During that time necrotizing funisitis was not found to be associated with any other infection. The relationship was unexpected on the basis of current knowledge of the condition, but we found the older medical literature documents syphilis as the virtually specific cause of deep funisitis with angiophlebitis. Necrotizing funisitis has a characteristic macroscopic appearance, the "barberpole" cord, that permits the presumptive diagnosis of congenital syphilis at the time of birth.

Autopsy↗
PubMed1985

In vitro secretion of immunoglobulin in early syphilis evaluated with the plaque forming cell assay.

We have studied the secretion of immunoglobulin in vitro from blood lymphocytes in twenty-one patients with primary or secondary syphilis before and after treatment of their disease. Polyclonal activation of B lymphocytes with pokeweed mitogen is dependent upon T lymphocytes. Using the inversed haemolytic plaque cell assay we found a normal secretion in vitro of immunoglobulin in both primary and secondary syphilis. Our results indicate that patients with syphilis retain a normal immune regulation of B lymphocyte immunoglobulin secretion in vitro.

Adolescent↗
PubMed1977

[The Baie disease: was it syphilis?].

In 1773 an epidemic disease with cutaneous manifestations appeared in Baie Saint-Paul, Québec and spread rapidly from nearby les Eboulements to the entire island of Montreal. The epidemic was in many ways reminiscent of a typical outbreak of syphilis, a condition then well known in Europe. Dr. Charles Blake of Montreal, as well as Drs. James Bowman and Philippe Badelart of Quebec, would not acknowledge any other diagnosis. The latter two physicians were commissioned by General Haldimand, governor of Canada, to investigate and treat this new disease. Patients were often cured by potions or ointments containing mercury if used from the onset of symptoms. However, Dr. Robert Jones, another physician from Montreal, submitted a different opinion: the clinical course of the disease, the anomalies of its transmission, its sometimes intriguing sequelae and its unpredictable response to mercurial therapy led him to believe that it might be an entity entirely different from syphilis as it was then known in Europe. Half a century earlier, in Scotland, a similar outbreak had occurred for which the same reservation had been made with regard to a possible diagnosis of syphilis.

Disease Outbreaks↗
PubMed1987

Radionuclide imaging in a case of tertiary syphilis involving the liver and bones.

Tertiary syphilis is an unusual entity. We have encountered a case of tertiary syphilis of the liver and bone demonstrated by scintigraphy. With liver involvement, the liver scan showed focal defects due to gummas, and distortion due to scarring. Bone involvement was shown as increased cortical activity from periostitis, focal hot spots due to osteomyelitis, and cold defects due to gumma formation. Because syphilis is easily treated, but may not be as readily recognized, the diagnosis should be considered in cases of focal liver or bone disease of obscure etiology.

Adult↗
PubMedDate not supplied

[Syphilis in 1987].

The author recalls the main features of primary-secondary syphilis observed nowadays under any climat. Still present and in more young people, syphilis is no longer the plague it was in the past centuries, thanks to a quick and efficient treatment: penicillin. In case of allergia, cyclines and erythromycin are used. Serological, reaginic and specific tests must be associated and quantitative. Qualitative serology exposed by crosses is obsolete and without possible interpretation. Modern American terminology of early syphilis has no other interest than the therapy which varies according to the stage of the disease.

Female↗
PubMed1979

[Attempts at developing a syphilis vaccine (author's transl)].

Numerous investigators tried over the years to induce artifically immunity against syphilis by use of a variety of treponema preparations. None of these immunization experiments performed by different means and routes provided clear evidence of acquired immunity in animals and humans given various vaccine preparations against challenge with even minimal doses of virulent T. pallidum. In recent years, however, promising results have been obtained in the immunization study. Two types of syphilis vaccine have been developed which were found very effective in conferring a protection against syphilitic infection on rabbits: (1) the first vaccine contains T. pallidum attenuated by gamma irradiation, and the other one (2) contains T. pallidum killed by penicillin. In addition, it has been demonstrated that the immunogenic activity of T. pallidum is related to their very labile protein component. Pretty much is also known on the factors influencing the immune response of artificially immunized rabbits, and on the immunological mechanisms underlying the development of syphilis immunity.

Antigen-Antibody Reactions↗
PubMedDate not supplied

[Passive hemagglutination test in the serodiagnosis of syphilis].

Passive haemagglutination test with pathogenic Treponema pallidum antigen in the serodiagnosis of syphilis, carried out on 752 sera (518 syphilitic patients and 234 subjects without evidence of syphilis) showed a greater general sensitivity as compared the cardiolipin tests and complement fixation test with Reiter protein antigen, and lower, to immunofluorescence (FTA--ABS). Its specificity is relatively lower than that of the cardiolopin and treponemal tests. Associated with the cardiolipin test it may be preferably used for the detection of syphilis, and moreover, passive haemagglutination may confirm the diagnosis in case of weak positive results with the FTA--ABS test. The latter is, however, essential for problem cases.

Antigens, Bacterial↗
PubMed1985

Computed tomography and ultrasound appearance of liver disease in secondary syphilis.

Liver disease occurring as a manifestation of secondary syphilis is unusual, and this association is not readily recognized or considered in the differential diagnosis of obscure hepatic disease, thereby causing delay in treatment. We describe a case of liver involvement in secondary syphilis with computed-tomography and ultrasound findings. This entity should be considered in patients with hepatomegaly coexisting with the clinical stigmata of secondary syphilis, as treatment with penicillin results in rapid improvement in both the clinical and biochemical findings.

Adult↗
PubMed1985

[Visual and auditory evoked potentials in latent syphilis].

The evoked potentials visual and auditory are studied in 43 patients with latent syphilis without previous mucocutaneous lesions. Twenty nine of them had not received treatment, and 14 due to their positive serology were treated with benzathine penicillin. At the visual potential evoked there were no abnormalities but in 20 cases evoked auditive potential were abnormal. This findings suppose the existence of subclinical neurological indicates the existence of lesions in almost 50% of the cases of this period of syphilis. All these patients had positive circulate immune complexes and normal cerebro-spinal fluid. The neurological alteration consists in a lesion of the cerebral trunk. According to these results the auditory potential evoked test is very important. The authors doubt on the efficacity of the benzathine penicillin in this period of syphilis.

Adult↗
PubMed1985

Lumbar puncture in asymptomatic late syphilis. An analysis of the benefits and risks.

We evaluated the treatment of asymptomatic patients with untreated syphilis of more than one year's duration (asymptomatic late syphilis) using a decision-analysis model. Two strategies were compared: treatment with 7.2 million units of penicillin G benzathine, or performing a lumbar puncture to test for asymptomatic neurosyphilis followed by penicillin and management based on cerebrospinal fluid analysis. Estimates of probabilities of disease prevalence, test sensitivity, and cure and complication rates were derived from published studies. Both strategies resulted in a cure rate of at least 99.7% using the best estimates. Although the strategy using lumbar puncture results in a 0.2% higher cure rate, its rate of complications (0.3%) exceeds its marginal benefit. We conclude that a lumbar puncture offers little additional benefit and may increase morbidity in patients with asymptomatic late syphilis.

Headache↗
PubMed1979

Liver disease in early syphilis.

Atypical manifestations of early syphilis, although uncommon, may represent diagnostic difficulties and delay therapy. We describe two cases of hepatitis complicating early syphilis. Clues to the diagnosis of early syphilitic hepatitis include the presence of perianal lesions and disproportionate increases in the serum alkaline phosphatase level. Biopsy results were nonspecific. The major differential diagnostic consideration is hepatitis B with false-positive serologic findings. The abnormalities of liver function respond to standard therapy for secondary syphilis. Follow-up of patients and their contacts is essential.

Alkaline Phosphatase↗
PubMed1982

The role of immune complexes in early syphilis and in the Jarisch-Herxheimer reaction.

Circulating immune complexes (CIC) were detected in one of 11 patients with primary syphilis and in 5 of 12 patients with secondary syphilis. The level of CIC was significantly increased in patients with secondary syphilis. Four weeks later a significant decline in CIC was found. No relationship was demonstrated between CIC and affection of the skin, lymph nodes, or kidneys. An increased albumin excretion rate was demonstrated before treatment. No differences were found in the excretion rate of beta-2-microglobulin before or after treatment. Nineteen patients had a Jarisch-Herxheimer reaction during treatment. An increase in CIC was found in 5 patients and a decrease in 7 patients. No correlation could be demonstrated between the level of or changes in CIC and the severity of the Jarisch-Herxheimer reaction.

Adult↗
PubMed1983

Incidence of glomerulonephritis in congenital syphilis.

We present 5 patients with abnormal urinalysis from a series of 11 infants with congenital syphilis. Three of these 5 patients had a biopsy that demonstrated a membranous glomerulonephritis, and in two cases treponemal antigens were identified in the capillaries of the glomeruli. We suggest that glomerulonephritis with few clinical manifestations is a frequent complication of congenital syphilis and that every patient with congenital syphilis must be studied in order to detect alterations in glomerular function.

Antigen-Antibody Complex↗
PubMed1983

[Value of the indirect immunofluorescence test in syphilis and toxoplasma diagnosis].

The examination tests annually necessary for a serological examination for syphilis and toxoplasmosis are in the first place as to their quantity in the diagnostics of the infection. For the performance of this large number of tests the use of a method is necessary which corresponds to the necessities of rationalisation of the laboratory work in the same way as to the demands to quality, which is characterized by specificity, sensitivity and reproducibility. For these criteria in the framework of the syphilis serology the TPHA-test is in a higher degree sufficient (with the exception of the early syphilis) than the FTA-ABS-test. The small quantity of the imported test set which is at present at our disposal does not allow a general application of this test, so that the FTA-ABS-test is the most usual method. Moreover, by means of FTA-ABS-IgM and 19 S-IgM-FTA-ABS-test valuable diagnostic additional informations (early diagnosis of the infection, L. connata diagnostics, estimation of the success of therapy) can be got which neither the TPI nor the TPHA-test are able to give. For the diagnosis of toxoplasmosis the IFT shows at present a higher value of precision than ELISA. It is still to be clarified in how far in the higher sensitivity of toxoplasmosis ELISA unspecificities play a role.

Antibody Specificity↗
PubMedDate not supplied

Congenital syphilis: a diagnostic and therapeutic dilemma.

Seventy-eight newborn infants born to mothers with serologic evidence of syphilis (positive serum rapid plasma reagin and fluorescent treponemal antibody-absorption tests) were prospectively evaluated to derive diagnostic and therapeutic criteria for congenital syphilis. Sixty-one infants were asymptomatic with normal serum IgM and normal roentgenograms (Group I). Eight infants had clinical and/or laboratory evidence of infection at birth (Group II). Nine infants presented with late onset infection (Group III). Elevated serum IgM and abnormal roentgenologic findings were consistently present in symptomatic infants in Groups II and III. Cerebrospinal fluid (CSF) examination was normal in all asymptomatic infants and in all infants with late onset disease. One of the eight infants in Group II examined at birth had positive CSF Venereal Disease Research Laboratory determinations, but all other CSF findings were within normal limits, and a second infant with a slight increase in CSF protein had no clinical evidence of central nervous system (CNS) involvement. Of those asymptomatic infants who returned for follow-up 75% and 100% were seronegative by 3 and 6 months, respectively. The symptomatic infants remained seropositive up to 18 months of age. Infants who had no clinical evidence of CNS involvement at birth remained normal at follow-up and had normal CSF findings. The two infants with CNS symptoms at birth continued to have developmental delay despite normal CSF findings. The incidence of CNS involvement in congenital syphilis appears to be extremely low. The value of routine spinal fluid examination is discussed.

Fluorescent Antibody Technique↗
PubMed1980

[Optic nerve involvement in neuro-syphilis: diagnostic evaluation by pattern-reversal visual evoked potentials (VEP) (author's transl)].

Pattern-reversal visual evoked potentials (VEP) were recorded in 41 patients suffering from syphilis in different stages. --In a latent syphilis 3 from 50 eyes (6%) had abnormal VEPs although ophthalmological findings were normal. --In neuro-syphilis, however, 16 from 32 eyes (50%) showed delayed responses. Ophthalmological findings were much less abnormal: visual acuity in 12%, visual field in 19%, and either or both of them in 25%. Pupillary disturbances were observed in 62%.

Evoked Potentials↗