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Syphilis
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
The genus Treponema includes T. carateum, the causative agent of pinta, and T. pallidum. The latter species is subdivided into three subspecies: T. pallidum subspecies pallidum, which causes syphilis; T. pallidum subspecies pertenue, which causes yaws; and T. pallidum subspecies endemicum, which causes bejel. The subspecies causing pinta, yaws, and bejel are morphologically and serologically indistinguishable from T. pallidum (syphilis), so there is no test in current clinical use which can differentiate one of these treponemal infections from another. The transmission of yaws, pinta, or bejel is not via sexual contact and the clinical course of each disease is significantly different, which differentiates them from syphilis.
Health Professionals and Historic Human Research Ethics
Published in Howard Winet, Ethics for Bioengineering Scientists, 2021
During World War II (WWII) project patients were kept out of the draft by instructions to the local draft board, from the USPHS. Penicillin, an antibiotic effective against T. pallidum, was developed between 1941 and 1943. Because it was difficult to mass-produce, it remained available to the military only, during the war. Tuskegee study patients did not receive it during the project at any point after the war.
Chronic erythematous rash and lesions on trunk and limbs
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Secondary syphilis occurs about 6 weeks after a primary infection with Treponema pallidum. The skin lesions are preceded by a flu-like illness and painless lymphadenopathy. The rash is very variable and may consist of macules, papules, pustules and plaques ranging in colour from pink to mauve, orange to brown. There are often lesions on the palms and soles (Fig. 8.50), patchy alopecia and flat warty lesions on the genitalia (seeFig. 11.02, p. 259) and perianal skin. The diagnosis can be confirmed by demonstrating T. pallidum on dark ground microscopy (Fig. 11.04, p 259), and a +ve VDRL, which distinguishes it from all the other non-itchy rashes on the skin. For treatment see p. 259.
Investigating the microbial pathogens of sexually transmitted infections among heterosexual Vietnamese men with symptomatic urethritis
Published in The Aging Male, 2022
Bac Hoai Nguyen, Quan Minh Pham, Long Hoang, Andrea Sansone, Emmanuele A. Jannini, Chau Minh Tran
This is one of the very first studies investigating the microbial etiology of symptomatic urethritis in Vietnamese men. The present study shows the diversity of causative microorganisms detected by multiplex PCR of urethral swab samples. Similar to previous reports worldwide, C. trachomatis, N. gonorrhoeae, M. genitalium, U. urealyticum, U. parvum, and M. hominis were the most common pathogens of urethritis in men [5,15–19]. While T. vaginalis was a critical pathogen of STIs in several countries with high prevalences [16–18,20], it was only detected in one patient as a co-infected bacteria in this study. The presence of G. vaginalis in urethral samples has been reported at high rates, specifically in 14% of men with urethritis in Japan [19,21] but accounts for only 1.2% in the present study. Besides G. vaginalis, the prevalence of C. albicans, HSV2, and HSV1 are also minimal. These findings are similar to other studies [5,22]. On the other hand, with no positive case of T. pallidum, this study suggests that urethritis may not be an acute symptom of this pathogen. Indeed, T. pallidum is more likely to be detected in patients with serologic confirmations and other locations, particularly in ulcers, rather than in the urethra [23]. Findings from this study provide a deep understanding of microorganisms causing urethritis in men which is essential in clinical practice since multiplex PCR is not always available and accessible in Vietnam.
Thyroid gland involvement in secondary syphilis: a case report
Published in Acta Clinica Belgica, 2022
Thomas Strypens, Gudrun Alliet, Greet Roef, Linsey Winne
The differential diagnosis with an anaplastic thyroid carcinoma should be made due to the rapidly progressive increase in volume of the thyroid swelling as well as its ultrasonically ill-defined boundaries with embedded microcalcifications and the slimy aspect of the puncture fluid. However, associated uveitis and inflammatory laboratory results do not fit this diagnosis. Tuberculosis should also be included in the differential diagnosis. Tuberculosis of the thyroid gland is a rare condition with a reported incidence rate of 0.1–0.3% [16]. Concomitant disorders of the thyroid in tuberculosis of the thyroid are rare [16,17], but hyperthyroidism and hypothyroidism have been reported [16]. The majority of these cases had a primary focus elsewhere in the body with hematogenous spread. Other possible differential diagnoses are sarcoidosis, subacute granulomatous thyroiditis, other bacterial thyroid abscess and lymphoma but were excluded due to the positive test results for T. pallidum.
Neuro-Ophthalmic Manifestations of HIV Infection
Published in Ocular Immunology and Inflammation, 2020
Lynn K. Gordon, Helen Danesh-Meyer
Syphilis is a multi-organ infection caused by the spirochete, Treponema pallidum. Because of its variable manifestations, syphilis can mimic many other inflammatories, infectious, and autoimmune optic neuropathies and is often referred to as the ‘great mimicker’.64–66 T. pallidum is transmitted most commonly by sexual contact from infected individuals during the first and second stages of their disease although it can also be passed from mother-to-fetus through the placenta or birth canal (congenital syphilis). A diagnosis of neurosyphilis is challenging in that it generally requires neurologic or ophthalmic manifestations with positive serology and abnormal CSF containing one of the following: pleocytosis or positive CSF VDRL.67,68 The diagnosis may be complex as HIV alone may cause a low pleocytosis and patients with an undetectable plasma HIV viral load are also less likely to have a CSF pleocytosis.