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Background The global resurgence of syphilis necessitates vaccine development. Methods We collected ulcer exudates and blood from 17 participants with primary syphilis (PS) and skin biopsies and blood from 51 patients with secondary syphilis (SS) in Guangzhou, China, for Treponema pallidum subsp pallidum (TPA) quantitative polymerase chain reaction, whole genome sequencing (WGS), and isolation of TPA in rabbits. Results TPA DNA was detected in 15 of 17 ulcer exudates and 3 of 17 blood PS specimens. TPA DNA was detected in 50 of 51 SS skin biopsies and 27 of 51 blood specimens. TPA was isolated from 47 rabbits with success rates of 71% (12/17) and 69% (35/51), respectively, from ulcer exudates and SS bloods. We obtained paired genomic sequences from 24 clinical samples and corresponding rabbit isolates. Six SS14- and 2 Nichols-clade genome pairs contained rare discordances. Forty-one of the 51 unique TPA genomes clustered within SS14 subgroups largely from East Asia, while 10 fell into Nichols C and E subgroups. Conclusions Our TPA detection rate was high from PS ulcer exudates and SS skin biopsies and over 50% from SS blood, with TPA isolation in more than two-thirds of samples. Our results support the use of WGS from rabbit isolates to inform vaccine development. [ABSTRACT FROM AUTHOR]

Background: The incidence of syphilis has clearly increased in Germany in recent years. This infectious disease has many forms of manifestation and can imitate surgical diseases. Material and methods: Comprehensive footage of experiences in a proctological center demonstrates these manifestations and explains the correct management. Results: The likelihood of confusion of syphilis with anal fissures, anogenital warts, proctitis and rectal cancer is high. Conclusion: Surgeons can encounter syphilis, the "chameleon of medicine" and must know the differential diagnoses. [ABSTRACT FROM AUTHOR]

The incidence and prevalence of syphilis are rising worldwide. Rectal syphilis is a rare condition with few reported cases in the literature and therefore often missed from differential diagnosis of atypical anorectal ulceration. We report a case of a 64-year-old male who presented with change in the bowel habit and a palpable rectal mass on examination. Colonoscopy revealed a small, ulcerated lesion in the rectum. However, histopathological analysis and radiological assessments were inconclusive. A cutaneous ulceration prompted a repeat biopsy and staining for spirochaetes, which was diagnostic of syphilitic proctitis. He was successfully treated with first line antibiotics via the Genitourinary Medicine clinic. With its increasing incidence, syphilis should be considered as a potential diagnosis of atypical anorectal ulceration. A complete sexual history including relevant risk factors should be taken and a full clinical examination performed actively looking for signs and symptoms of disease. [ABSTRACT FROM AUTHOR]

Field surveys were conducted in British Columbia fruit tree growing regions to determine the incidence of dieback and to identify the main fungal species causing cankers. Fruit trees showing cankers and dieback symptoms were recorded from 94% of orchards and 5.5% of trees surveyed. Overall, higher dieback incidence was observed in cherry than apple with 33% of cherry blocks showing between 5% and 26% of trees affected. Morphological studies along with DNA sequencing of the internal transcribed spacer (ITS) including the 5.8S rDNA, and parts of the translation elongation factor 1-α (TEF1), beta-tubulin (TUB2), and actin (ACT1) genes, identified seven fungi for the first time in fruit trees in Canada, including Calosphaeria pulchella, Cytospora parasitica, Cytospora populicola, Cytospora sorbicola, Ilyonectria robusta, Nectria dematiosa, and Phaeoacremonium minimum. In addition, this study reports for the first time Diplodia mutila and Diplodia seriata from cankers in sweet cherry in Canada. The already known fungal pathogens Neofabraea perennans and Neonectria ditissima were also identified. Pathogenicity studies showed N. ditissima and C. sorbicola to cause the largest vascular lesions in apple and cherry, respectively. This study identified the main fungal pathogens causing tree fruit cankers and dieback in British Columbia providing important information for the development of effective control strategies. [ABSTRACT FROM AUTHOR]

Dan Li,1 Ming Zhang,1 Jilai Yin,2,* Kai Chen1,* 1Department of Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan Province, People’s Republic of China; 2Department of Laboratory, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Kai Chen, Department of Dermatology, The Fifth People’s Hospital of Hainan Province, No. 8 Longhua Road, Longhua District, Haikou, Hainan Province, 570206, People’s Republic of China, Email bladetruth@126.com Jilai Yin, Department of Laboratory, the First Affiliated Hospital of Hainan Medical College, No. 31, Longhua Road, Haikou, Hainan Province, 570100, People’s Republic of China, Email 187295067@qq.comAbstract: A 18-year-old male presented with ulcers of lips and tongue and erythema of trunk of more than a month duration. Laboratory examinations for syphilis showed that TRUST (+) 1:32, TPPA (+), and HIV antibodies were negative. Combined with his case history and signs, he was diagnosed with secondary syphilis with chancre of lips and tongue and was cured by injecting benzathine penicillin 2.4 million U into gluteal muscles on both sides once a week for three times. After a month, the erythema and chancre disappeared. Three months later, the TRUST test was positive, the titer was 1:8, and the TPPA was positive.Keywords: chancre, secondary syphilis

Abstract Genital ulcers (GUs) represent a diagnostic challenge and can be secondary to neoplastic and inflammatory processes of different causes. Among those of infectious etiology, there are sexually transmitted infections (STIs), a very frequent reason for seeking the health service. The most common agents are herpes simplex virus and Treponema pallidum and, more rarely, Haemophilus ducreyi, Klebsiella granulomatis and Chlamydia trachomatis. A careful dermatological examination offers important diagnostic elements; however, atypical manifestations are very common. Distinctive characteristics of ulcers to look out for include their margin, edge, bottom, and base. Regional lymph node chain alterations should be evaluated regarding their number, size, mobility, consistency, inflammation, and pain on palpation. Diagnostic tests have variable sensitivity and specificity, and molecular tests are currently considered the reference exams. The rapid immunochromatographic tests represented a significant advance, as they can be performed with blood obtained from the digital pulp, offer results in up to 30 minutes, and do not require a laboratory structure. The treatment of persons affected by GU/STIs must be immediate, as it aims to prevent complications, as well as reduce transmission. It is not always considered that people with GUs/STIs have varying degrees of depression, anxiety, and self-reproach, with an impact on relationships. Establishing a bond and trusting the professional is essential for adherence to treatment and preventive measures that must be discussed individually.

Maculopapular eruptions are frequently described as large areas of rash characterised by red, small, confluent bumps. They are frequently puzzling for the attending clinician due to the multiple possible aetiologies. Accurate diagnosis is important because treatment varies depending on the aetiology, and some rashes can be life-threatening if not treated promptly. Common aetiologies implicated include drug allergies, infection-related (for example: viral exanthems, scarlet fever) and autoimmune conditions (for example: Still’s disease). We report a case of maculopapular eruption associated with mucocutaneous involvement and systemic symptoms. The possible differential diagnoses and approach to the management of this patient are discussed.

The aim of this paper is to remind the oral manifestations of acquired syphilis through the description of four cases diagnosed by oral lesions. The four cases considered patients in the first (1/4) or second stage of the disease (3/4), predominantly males (3/4), whose age at presentation was 20-54 years. An ulcer appeared in 2/4 patients and mucous patches in 2/4, all had non-painful, bilateral neck lymphadenitis, 2/4 described systemic signs and symptoms, and 2/4 had skin lesions consistent with syphilis. One patient belonged to the group of people living with human immunodeficiency virus (HIV). All were treated with penicillin. The oral manifestations of acquired syphilis consider mostly the first and second stage of the disease and are in the form of syphilis ulcer and mucous patches, respectively. The clinical presentation varies widely, in particular during the second stage, commonly leading to a delay in diagnosis. The synergetic association of acquired syphilis with HIV infection necessitates a high index of suspicion for syphilis in persons living with HIV. The diagnosis is confirmed by specific serologic tests. [ABSTRACT FROM AUTHOR]

Stem diseases of soybean with symptoms typical of infection by Diaporthe spp. are common in the Northern USA. Information is limited, however, on the characteristics of the associated pathogens. This study determined the identity and characteristics of Diaporthe spp. associated with symptomatic and asymptomatic soybean stems across diverse environments in Minnesota. Plants with symptoms of stem canker, pod and stem blight, and plant dieback, as well as asymptomatic plants, were sampled. Agar-based media and PCR assays were used to isolate and detect Diaporthe spp. from stems. The isolates were identified to species based on DNA sequencing and morphology. Diaporthe spp. were common in symptomatic and asymptomatic plants across all environments. Three species were detected: D. longicolla, D. caulivora, and D. cucurbitae. Diaporthe longicolla was the most widespread in distribution. Diaporthe cucurbitae was isolated from symptomatic soybean and confirmed to be a soybean pathogen for the first time. Only D. longicolla was detected in asymptomatic plants. While all isolates were pathogenic to soybean, virulence differed among isolates, and cultivars differed in susceptibility. Temperatures of 25°C and 32°C differentially influenced the growth of D. longicolla and D. caulivora. All isolates were sensitive to pyraclostrobin and tebuconazol. The results advance our understanding of the Diaporthe species associated with different soybean stem diseases, as well as their characteristics and management. [ABSTRACT FROM AUTHOR]

Background: Syphilis is an infectious disease caused by the spirochete Treponema pallidum, transmitted mainly by direct contact with the lesion. Primary syphilis usually presents with a chancre at the site of infection, which is highly contagious and resolves without treatment. The aim of this article is to illustrate an unusual location of a syphilitic chancre, in order to consider this diagnosis within the approach to patients with oral ulcers. Clinical case: a 30-year-old man who presented a dermatosis located in the left labial commissure, characterized by a painless ulcer of 1 cm in diameter of 20 days of evolution. The patient has a history of HIV/AIDS. A punch biopsy of the ulcer was performed with which the diagnosis of syphilitic chancre was made. The patient was treated with benzathine penicillin G, presenting resolution of the dermatosis. Conclusions: Primary syphilis is characterized by the development of the syphilitic chancre, which is the first manifestation of syphilis in up to 60% of cases. Extragenital presentation is rare, with only 12-14% of all cases, and of these between 40-70% occur in the mouth, being the lips the most frequent location. Oral manifestations can represent a diagnostic challenge due to its wide spectrum of clinical presentations. [ABSTRACT FROM AUTHOR]

A 61-year-old HIV+ male presented to an infectious disease clinic with a complaint of sore throat. A painless ulcerated mass was discovered on the right tonsil resulting in further evaluation with a CT scan of the neck. Imaging confirmed the presence of a mass centered on the palatine tonsil and associated lymphadenopathy. A presumptive diagnosis of HPV-related squamous cell carcinoma was made due to patient risk factors. However, multiple biopsies found no evidence of carcinoma, but instead revealed the presence of spirochetes that stained positive for T Pallidum. Soon after, the patient developed the characteristic copper-red maculopapular rash of secondary syphilis, indicating that the tonsillar mass was, in fact, a primary chancre. Since such chancres are most often found externally in the genital or anal region, they are seldom radiographically characterized, placing them low on the differential diagnosis for most radiologists. A high index of suspicion could aid future radiologists in placing primary syphilis higher on the differential diagnosis in similar cases in which the patient has appropriate risk factors, such as a known history of genital-oral sexually transmitted infections or an immunocompromised state. Prompt recognition of the nature of a primary syphilitic lesion can lead to rapid resolution of symptoms following treatment with intramuscular benzathine penicillin G, as eventually occurred in this case.

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introdução: As questões ligadas à nutrição têm peso cultural simbólico, sendo motivação na luta face à morte e uma temática controversa. Há conhecimento insuficiente face à nutrição artificial (NA) nas pessoas com cancro terminal, acreditando nos seus potenciais benefícios. A decisão deve ser uma interação entre profissional e pessoa doente atendendo às questões éticas e deontológicas, não permitindo a demissão ou alheamento da reflexão da praxis. Pessoas em fase terminal não experienciam fome e sede e a NA não apresenta benefícios na qualidade de vida. A Nutrição Alimentar é mais do que fisiológico, é social, psicológico e emocional. O profissional deve considerar as pessoas doentes parceiras e detentoras de saberes, património individual, dignidade humana e capacidade de tomada de decisão. Descreve-se a situação da pessoa acompanhada: a D. Ana tinha 68 anos, 4ª classe, católica. Apresentava diagnóstico de neoplasia do pâncreas há 8 anos, com diabetes mellitus secundária a quimioterapia. Após 4 anos surgiram metástases intestinais e realizou cirurgia para colostomia. Conhecedora da sua condição e ativa nas decisões. Dor 2. Sem Registo Nacional de Testamento Vital. Em 2018 a metastização conduziu a dependência moderada. Surgiram hipogeusia, anorexia e disfagia moderada (escala de Guss). Realizada conferência familiar. Recusou Sonda Naso Gástrica (SNG), mantendo refeições fracionadas e de acordo com a sua preferência e capacidade. Permaneceu em casa com controlo de sintomas. Após 5 semanas morreu de acordo com o desejo manifestado de não ser entubada.Objetivo: Refletir a prática centrada na pessoa com base no trabalho de equipa e legis artis.Método: Discussão de caso entre a Equipa Cuidados Continuados Integrados e equipa de saúde familiar dirigida à decisão da Ana e dificuldades surgidas nos profissionais, devido a valores, educação, (in)formação, aspetos pessoais e experiências. Focados aspetos vários: NA é guiada a prognóstico > 3 meses e boa performance (critério não verificado); Lei 31/2018; Norma 015/2013 da Direção Geral Saúde; Qualidade em Cuidados Paliativos; Código Deontológico: enfermeiros, médicos e assistentes sociais; princípios éticos: beneficência, justiça, autonomia e não maleficência. Resultados: A discussão para negligenciar argumentos individuais e constituir um momento de aprendizagem multidimensional, com maior ênfase na ética assentando na confrontação de perspetivas e respeito pela decisão da pessoa. A SNG pode ser ou não colocada avaliando a condição particular da pessoa e munindo a mesma da informação para decidir autonomamente.Conclusão: A decisão da pessoa norteia a intervenção e deve prevalecer, refletindo a unicidade e singularidade de cada condição. Estamos TODOS a dar atenção às pessoas e às suas reais necessidades e desejos? Estaremos NÓS a pensar SNG como Sobrevivência Nutricional Grosseira? Cuidar de alguém em equipa aproxima o outro do eu, transforma o eu no nós e permite fazer acontecer.

Introduction: Primary syphilis is classically represented by a hard chancre, but other rare forms such as Follmann’s balanitis are occasionally described. Objective: To show an iconography of the clinical presentations of the classic hard chancre and Follmann’s balanitis, in parallel with the serological results in the course of diagnosis and treatment. Methods: Descriptive case report of a patient of an outpatient clinic for sexually transmitted infections in a tertiary hospital in the city of São Paulo, SP, Brazil. Conclusion: Syphilis lesions acquire different clinical expressions according to the natural evolution of the disease. Recognizing these presentations, as well as knowing how to interpret the serological results, is essential for the diagnosis and adequate treatment of the infection.

Neodothiora populina Crous, G.C. Adams & Winton was determined to be a new pathogen of trembling aspen (Populus tremuloides) growing in Alaska, based on completion of Koch's Postulates in replicated forest and growth chamber inoculation trials. The pathogen is responsible for severe damage and widespread rapid mortality of sapling to mature aspen (≥ 80 years) in the boreal forests of interior Alaska, due to large diffuse annual (1–2 years) cankers. Isolation of the pathogen was challenging, and identification based on cultural characters was difficult. Fruiting bodies were not found on wild diseased trees, but erumpent pycnidia were found in bark overlying cankers on several stems inoculated with pure cultures. [ABSTRACT FROM AUTHOR]

Maculopapular eruptions are frequently described as large areas of rash characterised by red, small, confluent bumps. They are frequently puzzling for the attending clinician due to the multiple possible aetiologies. Accurate diagnosis is important because treatment varies depending on the aetiology, and some rashes can be life-threatening if not treated promptly. Common aetiologies implicated include drug allergies, infection-related (for example: viral exanthems, scarlet fever) and autoimmune conditions (for example: Still's disease). We report a case of maculopapular eruption associated with mucocutaneous involvement and systemic symptoms. The possible differential diagnoses and approach to the management of this patient are discussed. [ABSTRACT FROM AUTHOR]

To analyze the reasons of misdiagnosis of primary syphilitic chancre and strengthen the understanding of atypical features of this disease. A case series of twenty-seven challenging primary syphilis patients who were not immediately recognized as chancre was included in our study. The clinical data including the patients' age, sex, skin lesions, HIV status, syphilis serologic test results, treatment, and follow-up results were collected. Hematoxylin-eosin and immunohistochemistry staining of skin biopsy sections were reviewed. Four female cases with extragenital chancres presenting as erythema or erosive skin lesions on the nipple were misdiagnosed as Paget's disease or eczema. The disorder of missed or misdiagnosed male cases manifested as syphilitic balanitis or multiple chancres on the penis root and adjacent pubis rather than coronal sulcus or frenum. Patients with nonreactive nontreponemal tests at initial presentation were also easily missed or misdiagnosed. Primary syphilis presenting as multiple lesions rather than a single chancre, at atypical locations, or with a nonreactive nontreponemal test result, tends to be missed or misdiagnosed. [ABSTRACT FROM AUTHOR]

Despite advances in screening and treatment for syphilis, the US has seen increased incidence of the disease in the past decade. This article gives an overview of incidence, risk factors, clinical manifestations, assessment, screening, treatment, and prevention of syphilis. [ABSTRACT FROM AUTHOR]

Background: Syphilis is a sexually-transmitted infectious disease caused by Treponema pallidum. Cases of primary and secondary syphilis are on the rise in the United States, with a 14.4% increase in new cases noted from 2017 to 2018 and an escalation of 71% between the years 2014 and 2018. Fulfilling its nickname of "the great imitator," oral manifestations of syphilis may mimic a variety of infectious, neoplastic, or immune-mediated processes, both clinically and histopathologically. This large spectrum of appearances can create a diagnostic challenge to the clinician and/or pathologist, leading to delay in diagnosis or misdiagnosis. Methods: A database of oral syphilis cases was created from archives at the University of Kentucky, University of Pittsburgh, LIJMC, Columbia University MC, and University of Tennessee. The age, sex, race, location, duration, and clinical description were recorded. Cases without positive reaction upon immunohistochemistry or serologic tests were excluded. Results: We identified 19 new cases of oral syphilis (17 males, one female, and one case unknown sex) and described the clinical and histopathological features of this re-emerging and potentially fatal disease. All cases demonstrated dense lymphoplasmacytic inflammation, often with inflammatory exocytosis or ulceration at the surface, and perivascular inflammation. Conclusions: Early recognition of the histopathologic and clinical manifestations of oral syphilis is imperative for prompt diagnosis, improved patient outcomes, and disease prevention. [ABSTRACT FROM AUTHOR]

Two clinical cases of a complicated course of the primary period of syphilis are present. Attention deserves the severity of the clinical picture of a solid chancre, which could cause certain diagnostic difficulties.

Syphilis is a chronic inflammatory disease which is caused by the spirochete Treponema pallidum(T. pallidum) and is often sexually transmitted. The primary stage in syphilis classically presents with a painless ulcer which is evident in the genital area in more than 90% of patients and is commonly called as chancre. Extra genital chancres may differ from the classic ones based on the port of entry of the organism, in terms of localization, size, depth, base and edges thus, they may cause diagnostic problems.

Abstract Infections that cause genital ulcers are one of the themes comprising the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. The Protocol and Guidelines have been developed based on scientific evidence and validated in discussions with specialists. This article addresses clinical genital ulcer syndrome caused by sexually transmitted infections and its most common etiological agents: Treponema pallidum (syphilis), herpes simplex virus-2 (genital herpes) and herpes simplex virus-1 (perioral herpes), Haemophilus ducreyi (chancroid), Chlamydia trachomatis serotypes L1, L2 and L3 (lymphogranuloma venereum), and Klebsiella granulomatis (donovanosis). Epidemiological and clinical aspects of these infections and guidelines for their diagnosis and treatment are presented, including strategies for surveillance, prevention, and control actions to support health managers and professionals in the qualification of care.

Background: Whole-genome sequencing (WGS) of Treponema pallidum subspecies pallidum (TPA) has been constrained by the lack of in vitro cultivation methods for isolating spirochetes from patient samples.Methods: We built upon recently developed enrichment methods to sequence TPA directly from primary syphilis chancre swabs collected in Guangzhou, China.Results: By combining parallel, pooled whole-genome amplification with hybrid selection, we generated high-quality genomes from 4 of 8 chancre-swab samples and 2 of 2 rabbit-passaged isolates, all subjected to challenging storage conditions.Conclusions: This approach enabled the first WGS of Chinese samples without rabbit passage and provided insights into TPA genetic diversity in China. [ABSTRACT FROM AUTHOR]

Infection sexuellement transmissible ayant traversé les siècles, la syphilis connaît aujourd'hui une forte recrudescence. Les symptômes de cette maladie, caractérisée par trois stades cliniques, ne sont pas toujours facilement identifiables. Le pharmacien d'officine a un rôle important à jouer, aussi bien lors de la dispensation d'une ordonnance qu'en matière de prévention. A sexually transmitted infection that has lasted for centuries, syphilis is now on the rise again. The symptoms of this disease, characterized by three clinical stages, are not always easily identifiable. The pharmacist has an important role to play, both when dispensing a prescription and in terms of prevention. [ABSTRACT FROM AUTHOR]

Syphilis, a sexually transmitted disease, can be categorized as acquired syphilis and congenital syphilis, manifesting diverse lesions involving multiple sites. Oral manifestations at the primary stage of acquired syphilis are usually characterized by its short period and non-specific varied presentations. And oral ulcers as initial and the only presentation of syphilis oral lesions are infrequent and occur in less than 2% of patients. Because of its transient nature and variable manifestations which could mimic other oral ulcerative lesions, oral syphilis presenting as sole ulceration at early stage can be easily neglected and rather difficult to diagnose. Herein, we report a 35-year-old female patient manifested a sole atypical ulceration on her upper lip for approximately 1 month. We highlighted the importance of early and accurate diagnosis, focused on the characteristics of oral chancre, and gave an insight to the differential diagnoses, which would be enlightening and useful in clinical practice. [ABSTRACT FROM AUTHOR]

Copyright of Forestry Chronicle is the property of Canadian Institute of Forestry and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Forestry Chronicle is the property of Canadian Institute of Forestry and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de la Facultad de Odontología. Universidad Nacional de Cuyo is the property of Universidad Nacional de Cuyo, Facultad de Odontologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the spring of 2018, necrotic and canker symptoms were observed on stems of young apple trees that were bench-grafted by growers on four rootstocks (EMLA 9, Supporter 4, M9-T337 and Pajam 2) in Annapolis Valley, Nova Scotia. The objective of this study was to isolate and identify the causal organism of the disease on apple rootstocks. The diseased tissue obtained from eight infected plants of the four rootstocks showing visible necrotic and canker symptoms was used for microorganism isolation on potato dextrose agar (PDA). More than 90% of the isolates on PDA yielded a similar type of fungal colony. Based on the colony and spore morphology and presence of both α and β spores, Diaporthe was proposed as a major pathogen from the symptomatic tissue. Analysis of partial sequences of four unlinked loci DNA-lyase (APN2), histone-3 (HIS), translation elongation factor 1 alpha (TEF1-α) and the internal transcribed spacer (ITS) 5.8S region of rDNA of the representative fungal isolates from young apple trees confirmed its identity as D. eres (Phomopsis fukushii). The pathogenicity of the representative D. eres isolate was confirmed on 1-year-old young apple trees bench-grafted on four different rootstocks in greenhouse tests. Necrotic and sunken canker symptoms like those observed on the nursery-grown young apple trees appeared on stems of all inoculated plants. The necrotic and canker lesions were observed 3 days after inoculation; they spread both directions from the inoculation point and led to the death of the young plants after 4 weeks. To our knowledge, this is the first report of D. eres causing stem canker and death of young apple rootstock in Canada. [ABSTRACT FROM AUTHOR]

Introduction: Sexually transmitted diseases are defined as a group of infections caused by various agents which are acquired during sexual intercourse. They also tend to generate manifestations in the mouth. Objective: To determine the typical lesions in oral cavity of sexually transmitted diseases. Materials and methods: A descriptive transversal study was conducted with 37 patients who attended the stomatology services of the University of Buenos Aires, University of Cartagena and the Aleman Hospital in Buenos Aires during 2015 and 2016. A complete clinical history was carried out with Venereal Disease Research Laboratory (VDRL) and Fluorescent Treponemal Antibody Absortion (FTA-ABS) tests in patients with presumption of syphilis. In addition, histopathological analysis and Polymerase Chain Reaction (PCR) was made in patients with presumption of Human papillomavirus (HPV). Results: The average age of the patients was 38, where male sex predominated. 54.1% were diagnosed with syphilis and the most found lesion in them was the papule. The remaining 45.9% were diagnosed with HPV, the predominant lesion in them was a wart. Conclusions: The dentist should contribute to the early detection of sexually transmitted diseases by identifying manifestations of these in the mouth in order to prevent their evolution and prevent their transmission.

Since a brief low in 1998, reported cases of syphilis have continued to grow in the US. As primary care providers, NPs are at the forefront of the battle to eliminate syphilis. This article reviews the stages of this infection, diagnosis nuances, and treatment guidelines. [ABSTRACT FROM AUTHOR]

Syphilis is an increasingly diagnosed venereal disease which has four distinctive stages that may last over decades if appropriate treatment is not given. Review of the files of the Pathology Museum in the Faculty of Medicine at The University of Adelaide revealed three cases with classical cardiovascular and neurological findings. Case 1: An 80-year-old man with a large syphilitic aneurysm of the ascending aorta with a smaller aneurysm of the proximal descending aorta. Case 2: A 56-year-old man with chronic syphilitic meningoencephalitis with cerebral atrophy. Case 3: A 77-year-old man with tabes dorsalis. Given the increase in cases coming to medical attention in recent years due to high-risk sexual activity, migration, travel and reduced access to medical treatment, an awareness of the classical features of syphilis is appropriate as some cases will undoubtedly require medicolegal evaluation. [ABSTRACT FROM AUTHOR]

Abstract The aim of this study was to describe 40 cases of acquired oral syphilis (AOS) and to discuss the distribution of demographic characteristics, clinical features, and differential diagnosis of the disease. A retrospective study was conducted covering a 17-year period at a single institution in southern Brazil. Moreover, a literature review was performed through a search of the PubMed database for articles on AOS published between 1955 and March 2018. Data were analyzed descriptively. The predominant group within the case series was male patients in their twenties. The vast majority of cases (92.5%) were in the secondary stage of the disease. The lips were the most commonly affected site, with greyish-white mucous patches and reddish ulcers. In the literature review, the largest number of reported cases came from North America. Male patients in the third and fourth decades of life were most affected. AOS occurred more commonly as mucous patches and ulcers on the tongue and palate. Similarities regarding the distribution by sex, age, and anatomical location were found in the present study when compared to cases reported elsewhere. Clinicians, oral pathologists, and maxillofacial surgeons should familiarize themselves with the variable spectrum of signs and symptoms of AOS in their clinical practice to improve diagnosis and management. [ABSTRACT FROM AUTHOR]

History of present illness: A 28-year-old male presents to emergency department with a chief complaint of dysuria over the past seven days associated with a new penile lesion over the same period. He reports sexual activity with “many men and women” without condom use. His review of system is otherwise negative. Significant findings: Physical examination revealed a non-tender, erythematous lesion on the glans penis, two similar adjacent satellite lesions, as well as tender inguinal lymphadenopathy. No penile discharge was noted. Discussion: Syphilis is a sexually transmitted disease caused by Treponema pallidum. The early stage of the infection consists of three phases – primary syphilis, secondary syphilis and early latent syphilis. The late stage occurs amongst untreated patients, leading to asymptomatic chronic latent disease.2 The feared complication of latent disease is progression to tertiary syphilis, which may occur decades later and includes major cutaneous, musculoskeletal, cardiovascular, and neurological complications.1 Primary syphilis infection manifests as a chancre, a localized, typically painless skin lesion at the site of inoculation. The classic lesion forms a 1-2-centimeter ulcer with a raised, indurated margin commonly with associated moderate regional lymphadenopathy. Chancres are self-limited and heal within six weeks without treatment.2,5 Diagnosis can be made with nontreponemal tests (which are nonspecific) and treponemal tests (which are more complex and expensive, but specific). Nontreponemal tests include the rapid plasma regain (RPR) and venereal disease research laboratory (VDRL). The treponemal test of choice is the fluorescent treponemal antibody absorption (FTA-ABS). Darkfield microscopy in combination with direct fluorescent antibody testing can be used to identify the organism.1,5 The preferred treatment for early syphilis is a single dose of 2.4 million units of intramuscular penicillin G.1,3,4 Our patient was given this treatment, along with empiric coverage for gonorrhea and chlamydia co-infection with ceftriaxone and azithromycin. His RPR and FTA testing was positive, as was his chlamydia DNA PCR.

Multiple syphilitic chancre is not frequent in the immunocompetent patient. On the other hand, extragenital lesions are more common in the mouth and anus, and it is rare to find them in the breast. We report the case of an 18 year-old patient who attended the consultation with three syphilitic chancres: one on the vulva and one on each areola.

Keywords: tonsillitis; ulcer; chancre; syphilis; T. pallidum EN tonsillitis ulcer chancre syphilis T. pallidum 407 408 2 08/11/22 20220901 NES 220901 Case summary An otherwise healthy 28-year-old man was referred to the Otolaryngology, Head and Neck Surgery Clinic for recurrent intermittent pain and swelling of the right tonsil associated with sore throat approximately every other month for a year. Ulcer, tonsillitis, chancre, syphilis, T. pallidum. [Extracted from the article]

An atypical early primary syphilis case presentation with multiple umbilicated papular lesions on the penis and a nonreactive syphilis serology was misdiagnosed as molluscum contagiosum. Over a period of eight weeks, prior to dermatologic consultation, the papules enlarged, ulcerated, and healed. New plaque and patch formation on the penis and scrotum led to a differential diagnosis of inverse psoriasis vs. syphilis. Histological examination of a shave biopsy specimen revealed numerous Treponema pallidum organisms and repeat syphilis serological test results confirmed a syphilis diagnosis. Lesions responded to treatment with benzathine penicillin. One must keep a high index of suspicion for syphilis in light of its diverse presentation and increasing incidence. [ABSTRACT FROM AUTHOR]

Young olive trees showing wilting and trunk cankers were observed in an orchard in Antalya province, Turkey. The aerial symptoms associated with reddish brown cankers expanding from the root collar to the stem were leaf discolouration, defoliation, and twig dieback. APhytophthorasp. was consistently isolated from necrotic root and crown tissues of symptomatic trees. The causal agent of the disease was identified asPhytophthora inundataby morphological characteristics and comparison of sequences of the Internal Transcribed Spacer (ITS) region. Pathogenicity of the isolates was tested by stem inoculation and soil infestation using olive saplings. At the end of the experiments, lesions developed on both stems and roots, and root weight reduction occurred. This is the first report ofP. inundatacausing disease of olive trees in Turkey. [ABSTRACT FROM AUTHOR]

Extrapulmonary tuberculosis constitutes about 10% of all cases of tuberculosis, and cutaneous tuberculosis makes up only a small proportion of these cases. Despite prevention programs, tuberculosis is still progressing endemically in developing countries. Commonest clinical variant of cutaneous tuberculosis in our study was lupus vulgaris seen in 55% patients followed by scrufuloderma seen in 25% patients followed by orificial tuberculosis, tuberculosis verrucosa cutis, papulonecrotic tuberculid, and erythema induratum seen in 5% each. The commonest site of involvement was limbs seen in 50% patients followed by neck seen in 25% patients, face in 15%, and trunk in 10% patients. Maximum percentage of patients (55%) had duration of cutaneous tuberculosis between 6-12 months followed by 35% between 13-24 months, 5% had duration of cutaneous tuberculosis less than 6 months, and the rest 5% had duration more than 24 months. The commonest histopathological feature in our study was tuberculoid granuloma with epitheloid cell and Langhans giant cells seen in 70% patients, hyperkeratosis was seen in 15% patients and AFB bacilli were seen in 5% patients.