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Syphilis
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Treponema pallidum is easily transmitted by sexual contact, and an overwhelming majority of cases are transmitted by sexual intercourse. Endemic syphilis is transmitted non-venerally by close contact with an active lesion and occurs in communities living under poor hygiene conditions. Syphilis is rarely transmitted during transfusion of blood or blood products or through needle sharing by intravenous drug abusers. The organism generally enters the body through small breaches in epithelial surfaces of genital, anorectal, oropharyngeal, or other cutaneous sites; however; penetration of intact mucous membranes can occur. Once inside the body it rapidly disseminates. The incubation period for T. pallidum averages 3 weeks, but can range 10–90 days. During the incubation period infected patients have, by definition, neither clinical nor serologic evidence of disease but are potentially infectious. The period of greatest infectivity is early in the disease when a chancre, mucous patch, or condyloma latum is present. Infectivity decreases over time, and after 4 years it is very unlikely that an untreated individual will spread syphilis, even by sexual contact. The risk of infection during a single sexual encounter with an infected individual is up to 60% depending on the stage of disease, and approaches 100% after five sexual encounters [8].
Translating the Medical Record
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Immunodiagnostic or serodiagnostic tests study antigen-antibody reactions for diagnosis of infectious disease, autoimmune disorders, neoplastic disease, and immune allergies. They also test for blood grouping and typing, tissue and graft transplant matching, and cellular immunology. Serologic testing, also termed microbial immunology, evaluates antigens of bacteria, viruses, fungi, and parasites. Terms related to these procedures include polymerase chain reaction (PCR), rate nephelometry, flow cytometry, complement fixation (CF), and enzyme immunoassay (EIA). Serologic tests for syphilis (STS) include fluorescent treponemal antibody absorption (FTA-ABS), rapid plasma reagin (RPR), Venereal Disease Research Laboratory (VDRL), and microhemagglutination assay for Treponema pallidum antibodies (MHA-TP).
Mucosal immune responses to microbes in genital tract
Published in Phillip D. Smith, Richard S. Blumberg, Thomas T. MacDonald, Principles of Mucosal Immunology, 2020
Syphilis is transmitted through direct contact with a sore, which can occur on the external genitals, vagina, anus, mouth, or in the rectum. Penicillin is used to treat the causative agent of syphilis, the spirochete bacterium Treponema pallidum. However, if untreated, syphilis can result in three stages of disease progression. The primary stage manifests with a single or multiple sores (chancres). The chancre lasts 3–6 weeks, and it heals without treatment. However, if untreated, the infection progresses to the secondary stage. Skin rash (often on palms of the hands and bottoms of the feet) and mucous membrane lesions appear that may be accompanied by fever, fatigue, weight loss, and swollen lymph nodes during secondary syphilis. The symptoms of secondary syphilis will resolve without treatment, but the infection will progress to the latent and possibly late stages of disease. The latent stage of syphilis can last for years. Upon reactivation, a tertiary stage of syphilis ensues, in which the disease may damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. This damage can lead to difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, dementia, and even death.
Adverse pregnancy outcomes among pregnant women living with HIV in Hubei province, China: prevalence and risk factors
Published in AIDS Care, 2023
Mengmeng Wu, Yajun Yan, Shi Zou, Songjie Wu, Ling Feng, Yanbin Liu, Wei Guo, Weiming Tang, Ke Liang
Demographic information of the participants was collected via the Acquired Immune Deficiency Syndrome (AIDS) Comprehensive Prevention and Control Data Information Management System of the Chinese Center for Disease Control and Prevention (CDC), including age, ethnicity, marital status, HIV status of sexual partner, transmission route of HIV, the time of exposure to ARVs, and the antiretroviral regimens. Laboratory test of pregnant women living with HIV: the first CD4 count during pregnancy was determined by CD4 count test kit (the Beckman Coulter, Inc) and flow cytometry. Enzyme-linked immunosorbent assay tests are used to detect hepatitis B surface antigen (HBsAg), hepatitis C antibody (HCV-Ab), and treponema pallidum antibody (TP-Ab) in women living with HIV. Syphilis infection was diagnosed for positive treponema pallidum antibody test. HBV infection was diagnosed for positive HBsAg. Positive HCV-Ab was diagnosed as HCV infection.
CT findings in aggressive Takayasu arteritis
Published in Acta Cardiologica, 2022
Benjamín Roque Rodríguez, Luis Enrique Lezcano Gort, María Victoria Mogollón Jiménez, Ignacio Díaz Villalonga, Sergio Moyano Calvente, Zineb Kounka
A 52-year-old woman was referred to our hospital with grade-2 dyspnoea without intermittent claudication. She complained of self-limiting episodes of fever, asthenia, and myalgias since the adolescence. Physical examination revealed a loud panfocal systolic murmur (IV/VI), and large inter-arm blood pressure difference (180/80-120/70 mmHg in right and left arm respectively). Treponema pallidum serological-test and autoantibodies were negative, and acute phase reactants were normal. Doppler echocardiogram reveals doubtful patent ductus arteriosus. CT angiography with multiplanar (Figure 1, panels 1 and 4) and volumen-rendered reformatted images (Figure 1, panels 2 and 3) showed severe narrowing of the middle segment of the descending thoracic/abdominal aorta (a), and both iliac arteries, with intima-media thickening in all of them (b). Collaterals have been developed, like a huge and tortuous right internal mammary artery which anastomoses with branches of the epigastric arteries (c). We found severe stenosis in common carotid arteries (critical in left common carotid artery) (d) and in both subclavian arteries at the ostia of vertebral arteries(e). On the basis of clinical and angiographic abnormalities, the diagnosis of Takayasu arteritis (TA) was made. TA is a large-vessel granulomatous vasculitis that primarily affects the aorta and its primary branches, specially supraaortic trunk and subclavian artery. It principally affects young women. The patient refused to take any treatment or perform new tests. Actually, she remains asymptomatic.
Serologic false-positive reactions for syphilis in children of adenoidal hypertrophy:2 case reports and review of the literature
Published in Acta Clinica Belgica, 2021
Wei Wang, Xuzhou Fan, Xuelian Huang, Jingmei Yan, Jianfeng Luan
Syphilis, once epidemic only in low-income countries, is currently increasing at epidemic rates in high-income countries, mainly in men who have sex with men, women of reproductive age, and newborns [1]. As a chronic bacterial infection caused by Treponema Pallidum(TP), it is highly contagious and has a complicated pathogenic mechanism.Its transmission methods include sexual contact and vertical transmission [2]. Based on data from the World Health Organization (WHO), there are approximately 18 million syphilis patients worldwide in the year of 2012, and more than 5 million cases of syphilis are diagnosed all around the globe each year [3]. China, the most populous country in the world, has a high syphilis disease burden. It is estimated that there are approximately 3 million cases of syphilis in China, accounting for over 15% of the global estimate [4–6]. Syphilis has become a public health issue of close concern to the world.