Search

Background Syphilis diagnosis may be challenging, especially in the asymptomatic and early clinical stages. We evaluated the presence of Treponema pallidum DNA (TP-DNA) in various sample types to elucidate transmissibility during various syphilis stages. Methods The study was conducted at the Amsterdam Centre for Sexual Health. We included adult men who have sex with men (MSM), who were suspected of having syphilis. The 2020 European guidelines definitions were followed for the diagnosis and staging of syphilis. Using a polymerase chain reaction (PCR) targeting the polA gene of Treponema pallidum (TP-PCR), we tested the following study samples on TP-DNA: peripheral blood, oropharyngeal swab, ano-rectal swab, and urine. Results From November 2018 to December 2019 we included 293 MSM. Seventy clients had primary syphilis, 73 secondary syphilis, 86 early latent syphilis, 14 late latent syphilis, 23 treated syphilis, and 27 had no syphilis. TP-DNA was detected in at least 1 study sample in 35/70 clients with primary syphilis (2/70 peripheral blood, 7/70 oropharynx, 13/70 ano-rectum, and 24/70 urine); in 62/73 clients with secondary syphilis (15/73 peripheral blood, 47/73 oropharynx, 37/73 ano-rectum, and 26/73 urine); and in 29/86 clients with early latent syphilis (5/86 peripheral blood, 21/86 oropharynx, 11/86 ano-rectum, and 6/86 urine). TP-DNA was not detected in clients with late latent syphilis or treated syphilis, nor in clients without syphilis. Conclusions TP-DNA was frequently detected in various sample types in the absence of lesions. This is in line with the high transmission rate of syphilis and opens diagnostic opportunities for early presymptomatic syphilis stages. [ABSTRACT FROM AUTHOR]

The article explores a new specimen for syphilis diagnosis: evidence of high loads of Treponema pallidum DNA in saliva" , describes the polymerase chain reaction (PCR) detection of Treponema pallidum in blood and saliva specimens collected prior to treatment in patients with syphilis. The paper serves to validate and expand prior observations by Golden et al describing detection of T. pallidum in pharyngeal swab specimens.

The article informs about Clinical perspectives of Treponema pallidum sub species Endemicum infection in adults, particularly men who have sex with men in the Kansai area, Japan. Topics include results of genotyping using clinical specimens from patients with a clinical diagnosis of syphilis; and patients were each treated with amoxicillin and all had clinical and serological improvement.

The article presents case study of two man, one 64-year-old who had received a heart transplant in 2013 presented in Tours, France, in May 2016 with a 2-week history of fever and night sweats. And other 51-year-old diabetic man presented in Tours with ketoacidosis and septic shock 7 years after he had undergone liver transplantation for which he was still receiving immunosuppressive therapy.