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PubMed2005

Lues maligna in a chronic alcoholic patient.

Lues maligna, which is characterized by noduloulcerative lesions, is a rare form of secondary syphilis. It is mainly seen in either HIV-infected or malnourished patients suffering from a depression in immunity. We presented a chronic alcoholic, HIV negative male patient with noduloulcerative lesions diagnosed as lues maligna based on his skin eruptions, results of serologic tests, and, histopathologic findings. We believe that chronic alcoholism could be the cause of immunosuppression in our case and wanted to emphasize the possibility of an association between lues maligna and chronic alcoholism.

Adult↗
PubMed2006

Prevalence of hepatitis B, hepatitis C, human immunodeficiency virus, and syphilis among street children residing in southern Tehran, Iran.

Street children are among vulnerable people in the world. They are one of the main groups in the society who affect the pattern of health. To determine the prevalence of hepatitis B, hepatitis C, human immunodeficiency viruses (HIV), and syphilis among street children residing in southern Tehran, Iran. In a cross-sectional study, we selected 102 children aged below 15 years from southern Tehran. The selected children had an interview and were examined. From each child a blood sample was taken and tested for anti-HIV (ELISA), anti-HCV (ELISA), HBsAg (ELISA), anti-HBs, anti-HBc (radioimmunoassay [RIA]), rapid plasma reagin (RPR), and fluorescent treponema antibody absorption (FTA-ABS). We studied 39 (38%) boys and 63 (62%) girls, including 79 (77%) Afghan and 16 (16%) Iranian children. The nationality of 8 children could not be identified. The children were negative for syphilis, HIV, and HCV. Nevertheless, 3 of them were positive for HBsAg and 15 were HBsAb positive (>10 MIU/mL). The majority of street children are immigrants. Although these children did not have syphilis, HIV, and HCV, they are at risk of HBV.

Afghanistan↗
PubMed1991

[Serological investigation of HIV infections, HBsAg and syphilis in prostitutes in Elaziğ].

It is well known that the infections of AIDS, serum hepatitis and syphilis were transmitted by sexual contact. The sera of 66 prostitutes were investigated for determination of anti-HIV by ELISA, HBsAg by IHA and antibodies to syphilis by TPH methods in area of Elaziğ. The anti-HIV antibodies could not be detected in prostitutes, but HBsAg was positive in 13 (19.7%) and antibodies to syphilis was positive in 6 (9.1%) of total.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Rural sex work in Cambodia: work characteristics, risk behaviours, HIV, and syphilis.

OBJECTIVE: To identify prevalence and risks factors for syphilis and HIV among rural female sex workers (FSWs) in Cambodia and to describe differences between rural and urban FSWs. METHODS: Interviews and sera were collected from 114 FSWs and tested for HIV using the Serodia-HIV test and positives confirmed with the enzyme linked immunosorbent assay. Syphilis was tested for with the rapid plasma reagin with passive particle agglutination test for detection of antibody of Treponema pallidum. Study data were merged with data from a study of urban FSWs from Phnom Penh that applied similar questionnaires and sampling design to compare STI prevalence and behaviours. RESULTS: 42% of rural FSWs were HIV positive; 22% had past or current syphilis. In multivariate models HIV was significantly associated with age > or = 25 (OR = 6.1 95% CI: 1.0 to 36.6), a non-commercial partner in the past year (OR= 0.33, 95% CI: 0.11 to 0.93), and prevalence of past or current syphilis (OR = 2.9, 95% CI: 1.0 to 8.8). There was significantly higher active syphilis (14% v 4%), older mean age (25 v 21), fewer daily clients (2 v 5), lower monthly income (61 US dollars v 174 US dollars), and longer duration of sex work (2.3 years v 1.4 years) among rural than among urban FSWs. CONCLUSIONS: These findings reveal a high burden of HIV and syphilis among FSWs in rural Cambodia. As FSWs age and become infected with STI/HIV they may move out of cities into less competitive but less savvy markets; their high mobility may contribute to the expansion of the HIV epidemic into rural Cambodia and lower risk populations.

Adult↗
PubMed1993

Identification and partial characterization of a group of weakly beta-hemolytic intestinal spirochetes of swine distinct from Serpulina innocens isolate B256.

Comparative analyses of a group of 16 weakly beta-hemolytic spirochetes isolated from feces and mucosal scrapings of intestines of swine in the midwestern United States, and eastern Canada revealed the existence of a phenotypically and genotypically related group of 7 isolates. Although isolates in this group differed from all known reference isolates of intestinal spirochetes of swine, partial similarity was detected with S. joneseae isolate 16, a newly identified weakly beta-hemolytic intestinal spirochete of human beings. In addition to producing weak beta-hemolysis on blood agar plates, S. innocens isolates B256 and 4/71, S. joneseae isolate 16, and the 16 field isolates lacked the characteristic ring phenomenon described for Serpulina hyodysenteriae, an enteropathogenic spirochete of swine. All but one of the field isolates of weakly beta-hemolytic intestinal spirochetes gave negative results for indole production. The same isolates yielded variable results for alpha-galactosidase production. By transmission electron microscopic examination of negatively-stained cross-sections of spirochetes, the isolates segregated into groups containing either 4 to 7 or 9 to 16 profiles of axial filaments per cell cross-section. Analyses of genomic DNA of selected isolates using whole-genome cross-hybridization revealed a single genetic type consisting of 7 field isolates of weakly beta-hemolytic intestinal spirochetes. The 7 field isolates were distinct from the reference isolates S. innocens isolates B256 and 4/71, S. hyodysenteriae isolates B78 and B204, and Treponema succinifaciens isolate 6091 based on the number of axial filaments per cell cross-section and lack of cross-hybridization signal. S. joneseae isolate 16, had the same number of axial filaments per cell cross-section and produced a weak hybridization signal with a representative isolate of the 7 weakly beta-hemolytic field isolates from swine. This report suggests the existence of a widely distributed group of closely related weakly beta-hemolytic intestinal spirochetes of swine with genotypic characteristics distinct from S. innocens isolate B256.

Animals↗
PubMed1991

[Fundamental study on serological diagnosis of amoebiasis. 3. Serological survey of amoebiasis in blood donors showing seropositive for syphilis].

Sera of 375 blood donors which were seropositive for syphilis were examined for antibodies against Entamoeba histolytica. Antibody prevalences against E. histolytica using complement fixation (CF) test were 12.0%, and enzyme-linked immunosorbent assay (ELISA) were 2.7%. The positive rates of antibodies in the CF test were significantly higher in sera showing positive by the Venereal Disease Research Laboratory (VDRL) test than in the VDRL-negative sera, and not related to the results of Treponema pallidum hemagglutination (TPHA) test. Only one sample in the VDRL-negative sera was positive by CF test. On the other hand, the positive rates or mean absorbance in ELISA were not correlated to the results of VDRL or TPHA test. The percent positivity in CF test became higher with the level of antibodies in VDRL test, but not that in ELISA. The level of antibodies in CF and VDRL test were weakly correlated. These results suggested that the results of CF test for E. histolytica antibodies were most likely false-positive in relation to the results of VDRL test. 10 (2.7%) of sera were positive by ELISA, but all ELISA-positive samples showed low ELISA titers and absorbance. 9 of the ELISA-positive samples showed indirect fluorescent antibody (IFA) titers of over 1:50, and the level of antibodies in the IFA test correlated to that in ELISA, so ELISA-positive persons seemed to have been previous infected or were asymptomatic cyst carriers.

Adolescent↗
PubMed2002

The endemic treponematoses.

Treponemal diseases comprise venereal syphilis (Treponema pallidum subsp. pallidum) and the endemic (non-venereal) treponematoses, i.e. yaws (T. pallidum subsp. pertenue), endemic syphilis (T. pallidum subsp. endemicum) and pinta (T. carateum). Treponemal diseases are distinguished on the basis of epidemiological characteristics and clinical manifestations. They are at present indistinguishable by morphological, immunological or serological methods. Several minor genetic differences have been identified among the subspecies. The endemic treponematoses have not yet been eliminated and are currently thought to affect at least 2.5 million persons. Renewed action towards the elimination of these diseases should be undertaken.

Endemic Diseases↗
PubMed1993

A species-specific periplasmic flagellar protein of Serpulina (Treponema) hyodysenteriae.

We have previously reported that a 46-kDa protein present in an outer membrane protein preparation seemed to be a species-specific antigen of Serpulina hyodysenteriae (Z. S. Li, N. S. Jensen, M. Bélanger, M.-C. L'Espérance, and M. Jacques, J. Clin. Microbiol. 30:2941-2947, 1992). The objective of this study was to further characterize this antigen. A Western blot (immunoblot) analysis and immunogold labeling with a monospecific antiserum against this protein confirmed that the protein was present in all S. hyodysenteriae reference strains but not in the nonpathogenic organism Serpulina innocens. The immunogold labeling results also indicated that the protein was associated with the periplasmic flagella of S. hyodysenteriae. N-terminal amino acid sequencing confirmed that the protein was in fact a periplasmic flagellar sheath protein. The molecular mass of this protein, first estimated to be 46 kDa by Western blotting, was determined to be 44 kDa when the protein was evaluated more precisely by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and the protein was glycosylated, as determined by glycoprotein staining and also by N-glycosidase F treatment. Five other periplasmic flagellar proteins of S. hyodysenteriae, which may have been the core proteins and had molecular masses of 39, 35, 32, 30, and 29 kDa, were antigenically related and cross-reacted with the periplasmic flagellar proteins of S. innocens. Finally, serum from a pig experimentally infected with S. hyodysenteriae recognized the 44-kDa periplasmic flagellar sheath protein. Our results suggest that the 44-kDa periplasmic flagellar sheath protein of S. hyodysenteriae is a species-specific glycoprotein antigen.

Amino Acid Sequence↗
PubMed2000

Antibiotic selective markers and spirochete genetics.

Until very recently, the pathogenic spirochetes have been refractory to genetic manipulation. This has been due, in part, to difficulties with in vitro growth and the genetic distance that spirochetes are from typical Gram-negative and Gram-positive organisms. Insertional mutagenesis and other genetic techniques are now possible in some of the pathogenic spirochetes such as Borrelia burgdorferi, Brachyspira (Serpulina) hyodysenteriae, Leptospira sp., and Treponema denticola. However, organisms such as Treponema pallidum, which cannot be grown in vitro, are still not amenable to genetic manipulation. These recent advances have paved the way for more detailed genetic studies of transcriptional regulation, protein function, protein localization, metabolic capabilities, motility, and pathogenic nature of this group of spirochetes. This review article will discuss the current repertoire of antibiotic markers that are useful for spirochetal genetic manipulation. Further advances in selectable markers and shuttle vectors will allow researchers to complete Koch's molecular hypothesis for various virulence genes of the pathogenic spirochetes and increase the overall understanding of these challenging bacteria.

Animals↗
PubMed1984

Eliminating swine dysentery from selected herds.

In attempts to eliminate swine dysentery from a herd, the total cost of nitroimidazole medication in the water can be estimated at 16/gal over 3-4 weeks and for carbadox in the feed at 70/100 lb over 6-8 weeks. Use of dimetridazole or ipronidazole in the water for 3-4 weeks or carbadox in the feed for 6-8 weeks eliminates Treponema hyodysenteriae from the porcine gut. A 30-day (10 weeks with carbadox) preslaughter withdrawal time should be provided. Impervious surfaces should be thoroughly sanitized, while permeable surfaces and lots should be cleaned, dried and aired well for 2-3 weeks in warm, dry weather and for at least 60 days in cool, damp weather. Animal vectors and fomites must be controlled. Isolation of new breeding stock for 3-4 weeks helps prevent recontamination. While elimination of swine dysentery is not practical in many herds because of poor facilities or lack of producer commitment, a properly designed program can result in economic benefits.

Animals↗
PubMed1979

Studies on the pathogenesis of swine dysentery. II. Search for a cytotoxin in spirochetal broth cultures and colon content.

Broth cultures of Treponema hyodysenteriae and colonic content from pigs with swine dysentery were tested for cytotoxicity in cell cultures, erythrocyte suspensions and in ligated segments of pig colon. Live cells of T. hyodysenteriae attached to the surface of cells in all cultures tested but did not penetrate them nor cause morphologic change detectable by light microscopy. Only live T. hyodysenteriae caused erythrolysis. Broth cultures or colonic content sterilized by filtration or by disruption with ultrasound had no visible effect on the cell cultures, erythrocyte suspensions or the mucosa of ligated colonic segments.

Animals↗
PubMed1986

The antimicrobial activities of trimethoprim and sulfonamides.

The folate inhibitor trimethoprim (TMP) is active against and potentially cidal to a few higher microorganisms and a wide spectrum of pathogenic bacteria except for Bacteroides, Branhamella, Brucella, Chlamydia, Clostridium, Mycobacterium, Mycoplasma, Nocardia, Neisseria, Pseudomonas and Treponema. These organisms tend to be more sensitive to sulfonamides (SUL) than to TMP, whereas TMP is 10- to 100-fold more active than SUL against most other bacteria. Synergy between TMP and SUL occurs at drug concentrations equal to or less than their respective MICs and is often seen in vitro with isolates that are sensitive or moderately resistant to one or both of the components. Synergy occurs over a wide range of ratios between TMP and SUL, the optimal being that between their respective MICs when acting singly. In vitro synergy is more impaired by bacterial resistance than by suboptimal TMP:SUL ratios. The vast majority of clinical isolates of Haemophilus, staphylococci, streptococci and enteric bacteria are inhibited in vitro by the minimum concentrations of drug attained in plasma during therapy. Exceptions are found among Enterobacter, Citrobacter, Serratia, Proteus and in particular Klebsiella where SUL resistance is common and isolates with TMP MICs of 5 mg/l or more may occur and lead to failure of TMP-SUL therapy in systemic infections. In the urinary tract drug concentrations that are synergistic and therefore inhibitory in vitro against isolates moderately resistant to SUL (MIC less than or equal to 1 g/l) and/or TMP (MIC less than or equal to 0.1 g/l) are present during TMP-SUL therapy. However, whether the synergy and the bactericidal effect of TMP-SUL observed in vitro play a role in vivo is controversial.

Bacteria↗
PubMed2006

Nodules on the tongue in an HIV-positive patient.

Syphilis is a sexually transmitted disease caused by Treponema pallidum. Epidemiological studies show that rates have increased dramatically in recent y, especially in human immunodeficiency virus (HIV)-seropositive patients. Although lesions most frequently develop on the genital area, they are presently frequently detected in the oral cavity. We present an HIV-positive patient without antiretroviral treatment and immunologically stable, with firm nodules on the tongue. Following serological tests, clinical symptoms and histopathological findings, lesions were diagnosed as secondary syphilis. A spectacular improvement was achieved with specific treatment. To our knowledge this is the first case described in the literature of secondary syphilis presenting as nodular, painless lesions on the lingual mucosa.

Adult↗
PubMed1992

Detection of Borrelia burgdorferi DNA in urine samples and cerebrospinal fluid samples from patients with early and late Lyme neuroborreliosis by polymerase chain reaction.

A polymerase chain reaction (PCR) was developed for use in the identification of a 248-bp fragment of the Borrelia burgdorferi flagellin gene in urine and cerebrospinal fluid (CSF) from patients with Lyme neuroborreliosis. The specificities of the PCR products were confirmed by DNA-DNA hybridization with an internal probe. The assay had a detection limit of 10 in vitro-cultivated B. burgdorferi. The PCR assay seemed to be species wide as well as species specific, since DNA from all 21 B. burgdorferi isolates from humans tested but not from Borrelia hermsii or Treponema pallidum could be amplified. We tested 10 consecutively diagnosed patients with untreated neuroborreliosis. There was lymphocytic pleocytosis and intrathecal B. burgdorferi-specific antibody synthesis in the CSF of all patients. Urine and CSF samples were investigated by PCR before, during, and up to 8.5 months after therapy. B. burgdorferi DNA was detected in urine samples from nine patients; five patients, including two patients with chronic neuroborreliosis, were PCR positive prior to treatment, whereas urine samples from the remaining four patients obtained 3 to 6 days after the onset of therapy became PCR positive. All urine samples obtained greater than 4 weeks after therapy were negative by PCR. PCR of CSF was less sensitive, and samples from only four patients, including one with chronic neuroborreliosis, were positive. We conclude that urine is a more suitable sample source than CSF for use in B. burgdorferi DNA detection by PCR. Normalization of inflammatory CSF changes and the negative PCR results during follow-up even in patients with chronic neuroborreliosis do not point to a persistent infection. The future role of PCR as a diagnostic tool for Lyme neuroborreliosis is still uncertain.

Adolescent↗
PubMedDate not supplied

Microwave-accelerated cytochemical stains for the image analysis and the electron microscopic examination of light microscopy diagnostic slides.

Recent studies in our laboratories have shown how microwave (MW) irradiation can accelerate a number of tissue-processing techniques, especially staining, to aid in the preparation of single specimens on glass microscope slides or coverslips for examination by light microscopy (and electron microscopy, if required) for diagnostic purposes. Techniques have been developed, which give permanently stained preparations, that can be studied initially by light microscopy, their areas of interest mapped, and computer-automated image analysis performed to obtain quantitative information. This is readily performed after MW-accelerated staining with silver methenamine by the Giammara-Hanker PATS or PATS-TS reaction. This variation of the PAS reaction gives excellent markers for specific infectious agents such as lipopolysaccharides for gram-negative bacteria or mannans for fungi. It is also an excellent stain for glycogen and basement membranes and an excellent marker for type III collagen or reticulin in the endoneurium or perineurium of peripheral nerve or in the capillary walls. Our improved MW-accelerated Feulgen reaction with silver methenamine for nuclear DNA is useful to show the nuclei of bacteria and fungi as well as of cells they are infecting. Improved coating and penetration of tissue surfaces by thiocarbohydrazide bridging of ruthenium red, applied under MW-acceleration, render biologic specimens sufficiently conductive for SEM so that sputter coating with gold is unnecessary. The specimens treated with these highly visible electron-opaque stains can be screened with the light microscope after mounting in polyethylene glycol (PEG) and the structures or areas selected for EM study are mapped with a Micro-Locator slide. After removal of the water soluble PEG the specimens are remounted in the usual EM media for scanning electron microscopy (SEM) or transmission electron microscopy (TEM) study of the mapped areas. By comparing duplicate smears from areas of infection, such as two coverslips of buffy coat smears of blood from a patient with septicemia, the microorganisms responsible can occasionally be classified for antimicrobial therapy long before culture results are available; gram-negative bacteria are positive with the Giammara-Hanker PATS-TS stain, and gram-positive bacteria are positive with the SIGMA HT40 Gram stain. The gram-positive as well as gram-negative bacteria are both initially stained by the crystal violet component of the Gram stain. The crystal violet stain is readily removed from the gram-negative (but not the gram-positive) bacteria when the specimens are rinsed with alcohol/acetone. If this rinse step is omitted, the crystal violet remains attached to both gram-negative and gram-positive bacteria. It can then be rendered insoluble, electron-opaque, and conductive by treatment with silver methenamine solution under MW-irradiation. This metallized crystal violet is a more effective silver stain than the PATS-TS stain for a number of gram-negative spirochetes such as Treponema pallidum, the microbe that causes syphilis.

Acquired Immunodeficiency Syndrome↗
PubMed1980

[Recent developments in the field of syphilis serology (author's transl)].

All lipoid antigen tests are outdated except for the VDRL and RPR or RPRC and even these methods will be superseded in the near future. The TPI (Nelson-Mayer) test has been replaced by more reliable assays. The micro-haemagglutination assay with Tr. pallidum antigen (MHA-TP) or its automated version (AMPHA-TP) serve for screening. Reactive results in the AMPHA-TP have to be checked by the FTA-ABS. Reactivity to both tests indicates an infection with Tr. pallidum. The margin of error of this method is as low as 0.04 to 0.45%. The VDRL titre indicates, as yet, the activity of a syphilitic infection and the limit appears to be around 1 : 8. A decrease in the VDRL titre after adequate treatment suggests a successful therapeutic outcome. More reliable methods for assessing the necessity of treatment, as well as the results of therapy and the distinction between relapse and reinfection are provided by the identification of 19S-IgM-antibodies to Tr. pallidum by means of the 19S-IgM-FTA-ABS or the SPHA (SPIT) test. These assays will soon be available as routine procedures and their application will terminate the traditional era of lipoid antigen serology which has lasted for more than 70 years.

Antigens↗
PubMed1985

Syphilis in pregnant women in Mozambique.

To establish the prevalence of syphilis in pregnant women in Mozambique and evaluate present diagnostic methods, 1468 pregnant women in eight of the country's 10 provinces were examined using the Venereal Disease Research Laboratory (VDRL) test. Positive serum samples were also analysed using the Treponema pallidum haemagglutination (TPHA) assay and one group was also analysed using the fluorescent treponemal antibody absorbed (FTA-ABS) test. The prevalence of VDRL seroreactivity was found to be between 4.5% and 14.6%, whereas the prevalence of treponemal disease as verified by TPHA or FTA-ABS tests was between 1.6% and 9.8%. It is concluded that syphilis is relatively common among pregnant women in Mozambique. The predictive value of a positive VDRL test, when adequately performed, was

Female↗
PubMed2001

Human papillomaviruses and cervical cancer in Bangkok. I. Risk factors for invasive cervical carcinomas with human papillomavirus types 16 and 18 DNA.

Personal interviews, tests for antibodies to herpes simplex virus type 2, Treponema pallidum, and hepatitis B, tests for hepatitis B surface antigen (HBsAg), and polymerase chain reaction-based assays for human papillomavirus (HPV) DNA in cervical scrapings were obtained from 190 women with squamous cell and 42 women with adenomatous cervical carcinoma and from 291 hospitalized controls diagnosed in Bangkok, Thailand, between September 1991 and September 1993. Risk was strongly associated with oncogenic HPV types, with types 16 and 18 predominating in squamous and adenomatous lesions, respectively. The 126 cases with HPV-16 and the 42 cases with HPV-18 were compared with 250 controls with no evidence of any HPV. The risk of both viral tumor types increased with decreasing age at first intercourse in this predominantly monogamous population, which may be explained by more visits to prostitutes by the husbands of cases with early than late age at first intercourse. HPV-16 tumors were weakly associated with HBsAg carrier state and smoking. The risk of tumors of both viral types increased with parity and use of oral contraceptives but not with injectable progestogens. Factors that may predispose to persistent, oncogenic HPV-16 or -18 infection may include estrogens or progestins in the presence of estrogens, immunosuppression, and smoking, but other factors related to low socioeconomic status are also involved.

Adult↗