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James Matthias, Gayle Keller, Susan Cha, Craig Wilson, Thomas A Peterman
BACKGROUND: Before searching prior records, sexually transmitted disease (STD) programs use syphilis reactor grids to exclude some reactive non-treponemal test results (RNTs) based on patient age, sex, and test titer. We propose a new algorithm that starts with comparing RNTs to previous syphilis non-treponemal tests and current treponemal test results. METHODS: De-duplicated RNTs from Florida's surveillance system (2006-2015) were extracted and stratified on morbidity...
March 13, 2018: Sexually Transmitted Diseases
Ariel Schlaen, Mariana Ingolotti, Cristobal Couto, Mario Saravia
Purpose: To report the spectral domain optical coherence tomography (SD-OCT) features of a focal retinitis in an elderly male patient with bilateral syphilitic panuveitis. Observations: In the left eye (LE), spectral domain SD-OCT images during the active period revealed hyperreflectivity extending through the full thickness of the retina with no individualization of the layers, except for the retinal pigment epithelium. Once the lesion healed, SD-OCT imaging revealed an inner retinal atrophy and a mild disruption of the retinal pigment epithelium...
March 2018: American Journal of Ophthalmology Case Reports
Carmen Phang Romero Casas, Marrissa Martyn-St James, Jean Hamilton, Daniel S Marinho, Rodolfo Castro, Sue Harnan
OBJECTIVES: To undertake a systematic review and meta-analysis to evaluate the test performance including sensitivity and specificity of rapid immunochromatographic syphilis (ICS) point-of-care (POC) tests at antenatal clinics compared with reference standard tests (non-treponemal (TP) and TP tests) for active syphilis in pregnant women. METHODS: Five electronic databases were searched (PubMed, EMBASE, CRD, Cochrane Library and LILACS) to March 2016 for diagnostic accuracy studies of ICS test and standard reference tests for syphilis in pregnant women...
February 21, 2018: BMJ Open
Michelle Shuel, Kristy Hayden, Kamran Kadkhoda, Raymond Sw Tsang
BACKGROUND: The province of Manitoba, Canada, population of about 1.3 million, has been experiencing increased incidence of syphilis cases since 2015. In this study we examined the detection of T. pallidum DNA in 354 clinical samples from 2012 to 2016; and determined molecular types and mutations conferring resistance to azithromycin in the PCR-positive samples. METHODS: T. pallidum DNA detection was done by PCR amplification of tpp47, bmp, and polA genes. Syphilis serology results were reviewed for the PCR-positive cases...
October 5, 2017: Sexually Transmitted Diseases
Michael Marks, Oriol Mitjà, Christian Bottomley, Cynthia Kwakye, Wendy Houinei, Mathias Bauri, Paul Adwere, Abdul A Abdulai, Fredrick Dua, Laud Boateng, James Wangi, Sally-Ann Ohene, Regina Wangnapi, Shirley V Simpson, Helen Miag, Kennedy K Addo, Laud A Basing, Damien Danavall, Kai H Chi, Allan Pillay, Ronald Ballard, Anthony W Solomon, Cheng Y Chen, Sibauk V Bieb, Yaw Adu-Sarkodie, David C W Mabey, Kingsley Asiedu
BACKGROUND: A dose of 30 mg/kg of azithromycin is recommended for treatment of yaws, a disease targeted for global eradication. Treatment with 20 mg/kg of azithromycin is recommended for the elimination of trachoma as a public health problem. In some settings, these diseases are co-endemic. We aimed to determine the efficacy of 20 mg/kg of azithromycin compared with 30 mg/kg azithromycin for the treatment of active and latent yaws. METHODS: We did a non-inferiority, open-label, randomised controlled trial in children aged 6-15 years who were recruited from schools in Ghana and schools and the community in Papua New Guinea...
February 15, 2018: Lancet Global Health
Angel A Noda, Linda Grillová, Reto Lienhard, Orestes Blanco, Islay Rodríguez, David Šmajs
OBJECTIVES: Bejel, caused by Treponema pallidum subsp. endemicum (TEN), was until now considered as a non-venereal disease endemic in areas with hot and dry climates. This study has identified TEN in clinical samples from Cuban patients previously diagnosed with syphilis. METHODS: We performed sequencing-based molecular typing on 92 samples from Cuban patients diagnosed with syphilis. Moreover, to differentiate T. pallidum subspecies, Multi-Locus Sequence Analysis (MLSA) was designed, and applied to suspicious samples...
February 15, 2018: Clinical Microbiology and Infection
Olivia C Smibert, Adam W J Jenney, Denis W Spelman
Given the long term sequelae of untreated neurosyphilis and insensitive tests to detect treponemes in the cerebrospinal fluid, questions regarding the utility of a lumbar puncture and cerebrospinal fluid analysis either to confirm or exclude neurosyphilis are raised.
February 2018: Internal Medicine Journal
Sarah Heston, Sandra Arnold
Syphilis, caused by Treponema pallidum, is transmitted both sexually and transplacentally. Untreated syphilis is a progressive disease that may result in death or disability in children and adults. Syphilis diagnosis requires 2-stage serologic testing for nontreponemal and treponemal antibodies. Congenital syphilis diagnosis requires careful review of maternal testing and treatment, comparison of maternal and neonatal nontreponemal antibody titers, and clinical evaluation of the neonate. In this review, we present the current epidemiology of syphilis, and the clinical manifestations, diagnosis, and management of syphilis as they relate to pediatric practice, specifically, congenital syphilis and acquired syphilis in adolescents and pregnant women...
March 2018: Infectious Disease Clinics of North America
Ana Iglesias Plaza, Maribel Iglesias Sancho, Mónica Quintana Codina, Javier García Miguel, Montse Salleras Redonnet
Inhibitors of tumor necrosis factor-alpha (anti-TNF-alpha) are widely used in different medical specialties. The main adverse effect of these agents is the increased risk of infection. We report the case of a 30-year-old man with ankylosing spondylitis who had begun receiving golimumab two weeks earlier. He presented with a 10-day history of salmon-colored lesions on trunk, palms and soles. The clinical suspicion was secondary syphilis. Treponemal and nontreponemal tests confirmed the diagnosis of syphilis...
February 2, 2018: Reumatología Clinica
Zhong-Shuai Wang, Xiao-Ke Liu, Jun Li
Background: Some syphilitic patients remain in a serologically positive state after the recommended therapy. Although we often retreat patients in clinical practice, the optimal treatment protocol remains uncertain due to the paucity of data regarding serological response to retreatment and long-term outcomes. Methods: We examined rapid plasma reagin serological test results of 70 serofast early syphilis cases who were retreated with 2.4 million units of benzathine penicillin weekly for 3 weeks...
January 31, 2018: Journal of Antimicrobial Chemotherapy
L X Dou, Q Wang, X Y Wang, Y P Qiao, M Su, X Jin, A L Wang
Objective: To analyze serologic surveillance indicators during pregnancy among syphilis-infected women who delivered in 2013 in East China. Methods: Data were from national 'Information System of Prevention of Mother-to-child Transmission of HIV, syphilis and HBV Management' and in total 5 206 syphilis-infected pregnant women who delivered in 2013 and in East China were involved in the analysis. Information on demographic characters, laboratory tests, and treatment regimens were collected. The maternal non-treponemal testing surveillance and titer distribution were described and compare the proportions between pregnant women receiving standard testing and non-standard testing, taking baseline testing and testing before delivery or at the third trimester...
January 6, 2018: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
Michal Strouhal, Jan Oppelt, Lenka Mikalová, Natasha Arora, Kay Nieselt, Fernando González-Candelas, David Šmajs
OBJECTIVE: Treponema pallidum subsp. pallidum (TPA) is the causative agent of syphilis. Genetic analyses of TPA reference strains and human clinical isolates have revealed two genetically distinct groups of syphilis-causing treponemes, called Nichols-like and SS14-like groups. So far, no genetic intermediates, i.e. strains containing a mixed pattern of Nichols-like and SS14-like genomic sequences, have been identified. Recently, Sun et al. (Oncotarget 2016.
January 11, 2018: BMC Research Notes
Cassandra Tansey, Chunxia Zhao, Andre Hopkins, Jana M Ritter, Yetunde F Fakile, Allan Pillay, Samantha S Katz, Lara Pereira, James Mitchell, Frank Deyounks, Ellen N Kersh, Janet M McNicholl, Sundaram Ajay Vishwanathan
Men, diagnosed with syphilis or other rectal sexually transmitted infections (STIs), who have sex with men (MSM) are at a higher risk for HIV acquisition, which is concerning given the large increase in recently reported syphilis cases in the United States. We have developed the first non-human primate model for rectally transmitted syphilis by exposing SHIV-infected and naïve rhesus macaques to Treponema pallidum in the rectum. All animals showed mucosal lesions, systemic dissemination, and seroconversion (treponemal antibodies)...
December 22, 2017: Journal of Infectious Diseases
Kristina Adachi, Jiahong Xu, Nava Yeganeh, Margaret Camarca, Mariza G Morgado, D Heather Watts, Lynne M Mofenson, Valdilea G Veloso, Jose Henrique Pilotto, Esau Joao, Glenda Gray, Gerhard Theron, Breno Santos, Rosana Fonseca, Regis Kreitchmann, Jorge Pinto, Marisa M Mussi-Pinhata, Mariana Ceriotto, Daisy Maria Machado, Yvonne J Bryson, Beatriz Grinsztejn, Jack Moye, Jeffrey D Klausner, Claire C Bristow, Ruth Dickover, Mark Mirochnick, Karin Nielsen-Saines
BACKGROUND: Sexually transmitted infections (STIs) including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (TP), and cytomegalovirus (CMV) may lead to adverse pregnancy and infant outcomes. The role of combined maternal STIs in HIV mother-to-child transmission (MTCT) was evaluated in mother-infant pairs from NICHD HPTN 040. METHODOLOGY: Urine samples from HIV-infected pregnant women during labor were tested by polymerase chain reaction (PCR) for CT, NG, and CMV...
2018: PloS One
More Mungati, Anna Machiha, Owen Mugurungi, Mufuta Tshimanga, Peter H Kilmarx, Justice Nyakura, Gerald Shambira, Vitalis Kupara, David A Lewis, Elizabeth Gonese, Beth A Tippett Barr, H Hunter Handsfield, Cornelis A Rietmeijer
BACKGROUND: In many countries, sexually transmitted infections (STIs) are treated syndromically. Thus, patients diagnosed as having genital ulcer disease (GUD) in Zimbabwe receive a combination of antimicrobials to treat syphilis, chancroid, lymphogranuloma venereum (LGV), and genital herpes. Periodic studies are necessary to assess the current etiology of GUD and assure the appropriateness of current treatment guidelines. MATERIALS AND METHODS: We selected 6 geographically diverse clinics in Zimbabwe serving high numbers of STI cases to enroll men and women with STI syndromes, including GUD...
January 2018: Sexually Transmitted Diseases
Antonella Zorzi, Maddalena Cordioli, Lorenzo Gios, Paola Del Bravo, Igor Toskin, Rosanna W Peeling, Karel Blondeel, Giuseppe Cornaglia, James Kiarie, Ronald Ballard, Massimo Mirandola
OBJECTIVES: The incidence of HIV and syphilis among men who have sex with men (MSM) in Europe has recently increased. Rapid point-of-care tests (POCTs) for syphilis can improve access to screening. The purpose of this study was to evaluate the performance of two syphilis POCTs compared with laboratory tests among MSM. METHODS: The study was undertaken in Verona, Italy. Asymptomatic MSM, potentially exposed to syphilis, were enrolled prospectively. The POCTs evaluated were SD Bioline Syphilis 3...
December 2017: Sexually Transmitted Infections
Maria Luiza Bazzo, Leonardo Rapone da Motta, Renata Cristina Messores Rudolf-Oliveira, Alisson Bigolin, Lisléia Golfetto, Fábio Mesquita, Adele Schwartz Benzaken, Pamela Cristina Gaspar, Ana Flavia Nacif P Coelho Pires, Orlando da Costa Ferreira Júnior, Miriam Franchini
OBJECTIVES: In 2012, the WHO estimated that 6 million new cases of syphilis per year would occur worldwide, including 937 000 in Brazil. Early diagnosis and treatment of syphilis are essential to reduce morbidity and prevent transmission. The availability of rapid tests (RTs) for this diagnosis means that testing can be performed more quickly, as a point-of-care test, even in non-laboratory environments and requires only simple technical training to antibodies detection. The objective of this study was to evaluate the performance and operational aspects of seven commercially available RTs for syphilis in Brazil...
December 2017: Sexually Transmitted Infections
Jung-In Kim, Ji-Hye Park, Ju-Yeon Choi, Ga-Young Lee, Won-Serk Kim
Background: Automated analyzer-based nontreponemal serological tests for syphilis (STS) have been used for several decades. Objective: In this study, we evaluated serological responses to treatment and proposed clinical guidelines for automated STS. Methods: This retrospective cohort study analyzed human immunodeficiency virus-negative syphilis patients who were diagnosed with automated rapid plasma reagin (auto RPR) tests as a nontreponemal STS, and who also received the fluorescent treponemal antibody-absorption test as a confirmatory test...
December 2017: Annals of Dermatology
Francesco Drago, Sanja Javor, Aurora Parodi
INTRODUCTION: During syphilis a compelling fight is engaged between the host's humoral and cellular immune responses that work to eliminate the infection and Treponema pallidum (T. pallidum) that manages to evade eradication and cause chronic infection. Different mechanisms are utilized by treponemes to overcome immunological response. Although penicillin (BPG) proved to be effective in quelling the early manifestations of the disease and consequently its contagiousness, questions remain about its ability to prevent the late complications and to provide a microbiological eradication in vivo...
December 1, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Sukhum Silpa-Archa, Janine M Preble, C Stephen Foster
PURPOSE: To report the novel application of nontreponemal and treponemal antibody to confirm diagnosis of ocular syphilis from vitreous samples. METHODS: Two distinct case reports emphasizing the importance of confirmatory vitreous treponemal antibody. Multimodal imaging of patients was also applied. RESULTS: We report two distinct cases with positive serum treponemal antibody but opposing vitreous treponemal antibody results. One case with a positive vitreous test responded well to antisyphilitic treatment...
November 22, 2017: Retinal Cases & Brief Reports
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