Syphilis: Diagnosis
Total Page：16
File Type：pdf, Size：1020Kb
Load more
Recommended publications
-
Information to Users
INFORMATION TO USERS This manuscript bas been reproJuced from the microfilm master. UMI films the text directly ftom the original or copy submitted. Thus, sorne thesis and dissertation copies are in typewriter face, while others may be itom any type ofcomputer printer. The quality oftbis reproduction is depeDdeDt apoD the quality of the copy sablDitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthlough, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will he noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning at the upper left-hand corner and continuing trom left to right in equal sections with sma1l overlaps. Each original is a1so photographed in one exposure and is included in reduced fonn at the back orthe book. Photographs ineluded in the original manuscript have been reproduced xerographically in this copy. Higher quality 6" x 9" black and white photographie prints are available for any photographs or illustrations appearing in this copy for an additional charge. Contact UMI directly to order. UMI A Bell & Howell Information Company 300 North Zeeb Raad, ADn AJbor MI 48106-1346 USA 313n61-4700 8OO1S21~ NOTE TO USERS The original manuscript received by UMI contains pages with slanted print. Pages were microfilmed as received. This reproduction is the best copy available UMI Oral spirochetes: contribution to oral malodor and formation ofspherical bodies by Angela De Ciccio A thesis submitted to the Faculty ofGraduate Studies and Research, McGill University, in partial fulfillment ofthe requirements for the degree ofMaster ofScience. -
Import of an Extinct Disease?
OBSERVATION Pinta in Austria (or Cuba?) Import of an Extinct Disease? Ingrid Woltsche-Kahr, MD; Bruno Schmidt, PhD; Werner Aberer, MD; Elisabeth Aberer, MD Background: Pinta, 1 of the 3 nonvenereal treponema- detection of spirochetes in the trunk lesion indicated early toses, is supposed to be extinct in most areas in South and secondary syphilis, but an extensive case history and the Central America, where it was once endemic. Only scat- clinical appearance fulfilled all criteria for pinta. tered foci may still remain in remote areas in the Brazilian rain forest, and the last case from Cuba was reported in 1975. Conclusion: The acquisition of a distinct clinical en- tity, pinta, in a country where it was formerly endemic Observation: A native Austrian woman, who had lived but now is believed to be extinct raises the question of for 7 years in Cuba and was married to a Cuban native, whether the disease is in fact extinct or whether syphilis developed a singular psoriasiform plaque on her trunk and pinta are so similar that no definite distinction is pos- and several brownish papulosquamous lesions on her sible in certain cases. palms and soles during a visit to her home in Austria. Positive serological findings for active syphilis and the Arch Dermatol. 1999;135:685-688 HE NONVENEREAL trepone- after the appearance of pintids), lesions matoses yaws, endemic marked by vitiligolike depigmentation are syphilis (bejel), and pinta the leading feature. These lesions are not are caused by an organism believed to be infectious. Histopathologi- that is morphologically and cal investigations show moderate acan- Tantigenically identical to the causative agent thosis, spongiosis, sometimes hyperkera- of venereal syphilis, Treponema pallidum. -
Molecular Studies of Treponema Pallidum
Fall 08 Molecular Studies of Treponema pallidum Craig Tipple Imperial College London Department of Medicine Section of Infectious Diseases Thesis submitted in fulfillment of the requirements for the degree of Doctor of Philosophy of Imperial College London 2013 1 Abstract Syphilis, caused by Treponema pallidum (T. pallidum), has re-emerged in the UK and globally. There are 11 million new cases annually. The WHO stated the urgent need for single-dose oral treatments for syphilis to replace penicillin injections. Azithromycin showed initial promise, but macrolide resistance-associated mutations are emerging. Response to treatment is monitored by serological assays that can take months to indicate treatment success, thus a new test for identifying treatment failure rapidly in future clinical trials is required. Molecular studies are key in syphilis research, as T. pallidum cannot be sustained in culture. The work presented in this thesis aimed to design and validate both a qPCR and a RT- qPCR to quantify T. pallidum in clinical samples and use these assays to characterise treatment responses to standard therapy by determining the rate of T. pallidum clearance from blood and ulcer exudates. Finally, using samples from three cross-sectional studies, it aimed to establish the prevalence of T. pallidum strains, including those with macrolide resistance in London and Colombo, Sri Lanka. The sensitivity of T. pallidum detection in ulcers was significantly higher than in blood samples, the likely result of higher bacterial loads in ulcers. RNA detection during primary and latent disease was more sensitive than DNA and higher RNA quantities were detected at all stages. Bacteraemic patients most often had secondary disease and HIV-1 infected patients had higher bacterial loads in primary chancres. -
Syphilis Onset Seizures, a Head CT Reveals an Acute CVA • 85 Yo Woman C/O Shooting Pains Down Her Simon J
• 43 yo woman with RUQ pain is found to have a liver mass on U/S, biopsy of the mass reveals granulomas • 26 yo man presents to the ED with new- Syphilis onset seizures, a Head CT reveals an acute CVA • 85 yo woman c/o shooting pains down her Simon J. Tsiouris, MD, MPH Assistant Professor of Clinical Medicine and Clinical Epidemiology arms and in her face for 2 years duration Division of Infectious Diseases College of Physicians and Surgeons • 36 yo man presents to his PMD with an Columbia University enlarging lymph node in his neck 55 yo man presents to the ER with chest pain radiating to his back, 19 yo man is seen at an STD clinic shortness of breath and is found to have this on Chest CT for a painless ulcer on his penis Aortic aneurysm rupture. Axial postcontrast image through the aortic arch reveals an aortic aneurysm with contrast penetrating the thrombus within the aneurysm (open arrow). Note the high attenuation material within the mediastinal fat (arrowheads), representing blood and indicating the presence of aneurysm rupture. 26 yo man presents to an ophthalmologist with progressive loss of vision in his Left eye, his fundoscopic exam looks like the picture on the left: Mercutio: “… a pox on your houses!” Romeo and Juliet, 1st Quarto, 1597, William Shakespeare Normal MID 15 Famous people who (probably) had syphilis • Ivan the Terrible • Henry VIII •Cortes • Francis I • Charles Baudelaire • Meriwether Lewis • Friedrich Nietzche • Gaetano Donizetti • Toulouse Lautrec • Al Capone Old World disease which always existed and happened •… New NewWorld World agent disease which mutatedwhich was and transmitted created a newto the Old Old World World? disease? to flare up around the time of New World exploration? The Great Pox – Origins of syphilis Syphilis in the 1500s • Pre-Colombian New World skeletal remains have bony lesions consistent with syphilis • T. -
Genetic Diversity in Treponema Pallidum: Implications for Pathogenesis, Evolution and Molecular Diagnostics of Syphilis and Yaws ⇑ David Šmajs A, , Steven J
Infection, Genetics and Evolution 12 (2012) 191–202 Contents lists available at SciVerse ScienceDirect Infection, Genetics and Evolution journal homepage: www.elsevier.com/locate/meegid Review Genetic diversity in Treponema pallidum: Implications for pathogenesis, evolution and molecular diagnostics of syphilis and yaws ⇑ David Šmajs a, , Steven J. Norris b, George M. Weinstock c a Department of Biology, Faculty of Medicine, Masaryk University, Kamenice 5, Building A6, 625 00 Brno, Czech Republic b Department of Pathology and Laboratory Medicine, University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX 77030, USA c The Genome Institute, Washington University, 4444 Forest Park Avenue, Campus Box 8501, St. Louis, MO 63108, USA article info abstract Article history: Pathogenic uncultivable treponemes, similar to syphilis-causing Treponema pallidum subspecies pallidum, Received 21 September 2011 include T. pallidum ssp. pertenue, T. pallidum ssp. endemicum and Treponema carateum, which cause yaws, Received in revised form 5 December 2011 bejel and pinta, respectively. Genetic analyses of these pathogens revealed striking similarity among Accepted 7 December 2011 these bacteria and also a high degree of similarity to the rabbit pathogen, Treponema paraluiscuniculi,a Available online 15 December 2011 treponeme not infectious to humans. Genome comparisons between pallidum and non-pallidum trepo- nemes revealed genes with potential involvement in human infectivity, whereas comparisons between Keywords: pallidum and pertenue treponemes identified genes possibly involved in the high invasivity of syphilis Treponema pallidum treponemes. Genetic variability within syphilis strains is considered as the basis of syphilis molecular Treponema pallidum ssp. pertenue Treponema pallidum ssp. endemicum epidemiology with potential to detect more virulent strains, whereas genetic variability within a single Treponema paraluiscuniculi strain is related to its ability to elude the immune system of the host. -
Attachment of Treponema Denticola Strains to Monolayers of Epithelial Cells of Different Origin 29
PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/2066/145980 Please be advised that this information was generated on 2021-10-08 and may be subject to change. ATTACHMENT OF TREPONEMA DENTICOLA, IN PARTICULAR STRAIN ATCC 33520, TO EPITHELIAL CELLS AND ERYTHROCYTES. - AN IN VITRO STUDY - L—J Print: Offsetdrukkerij Ridderprint B.V., Ridderkerk ATTACHMENT OF TREPONEMA DENTICOLA, IN PARTICULAR STRAIN ATCC 33520, TO EPITHELIAL CELLS AND ERYTHROCYTES. - AN IN VITRO STUDY - een wetenschappelijke proeve op het gebied van de Medische Wetenschappen Proefschrift ter verkrijging van de graad van doctor aan de Katholieke Universiteit Nijmegen, volgens besluit van het College van Decanen in het openbaar te verdedigen op vrijdag 19 mei 1995 des namiddags te 3.30 uur precies door Robert Antoine Cornelius Keulers geboren op 4 april 1957 te Geertruidenberg Promotor: Prof. Dr. K.G. König. Co-promotores: Dr. J.C. Maltha Dr. F.H.M. Mikx Ouders, Familie, Vrienden Table of contents Page Chapter 1: General introduction 9 Chapter 2: Attachment of Treponema denticola strains to monolayers of epithelial cells of different origin 29 Chapter 3: Attachment of Treponema denticola strains ATCC 33520, ATCC 35405, Bll and Ny541 to a morphologically distinct population of rat palatal epithelial cells 35 Chapter 4: Involvement of treponemal surface-located protein and carbohydrate moieties in the attachment of Treponema denticola ATCC 33520 to cultured rat palatal epithelial cells 43 Chapter 5: Hemagglutination activity of Treponema denticola grown in serum-free medium in continuous culture 51 Chapter 6: Development of an in vitro model to study the invasion of oral spirochetes: A pilot study 59 Chapter 7: General discussion 71 Chapter 8: Summary, Samenvatting, References 85 Appendix: Ultrastructure of Treponema denticola ATCC 33520 113 Dankwoord 121 Curriculum vitae 123 Chapter 1 General introduction Table of contents chapter 1 Page 1.1. -
Genetic Diversity in Treponema Pallidum: Implications for Pathogenesis, Evolution and Molecular Diagnostics of Syphilis and Yaws ⇑ David Šmajs A, , Steven J
Infection, Genetics and Evolution 12 (2012) 191–202 Contents lists available at SciVerse ScienceDirect Infection, Genetics and Evolution journal homepage: www.elsevier.com/locate/meegid Review Genetic diversity in Treponema pallidum: Implications for pathogenesis, evolution and molecular diagnostics of syphilis and yaws ⇑ David Šmajs a, , Steven J. Norris b, George M. Weinstock c a Department of Biology, Faculty of Medicine, Masaryk University, Kamenice 5, Building A6, 625 00 Brno, Czech Republic b Department of Pathology and Laboratory Medicine, University of Texas Medical School at Houston, 6431 Fannin Street, Houston, TX 77030, USA c The Genome Institute, Washington University, 4444 Forest Park Avenue, Campus Box 8501, St. Louis, MO 63108, USA article info abstract Article history: Pathogenic uncultivable treponemes, similar to syphilis-causing Treponema pallidum subspecies pallidum, Received 21 September 2011 include T. pallidum ssp. pertenue, T. pallidum ssp. endemicum and Treponema carateum, which cause yaws, Received in revised form 5 December 2011 bejel and pinta, respectively. Genetic analyses of these pathogens revealed striking similarity among Accepted 7 December 2011 these bacteria and also a high degree of similarity to the rabbit pathogen, Treponema paraluiscuniculi,a Available online 15 December 2011 treponeme not infectious to humans. Genome comparisons between pallidum and non-pallidum trepo- nemes revealed genes with potential involvement in human infectivity, whereas comparisons between Keywords: pallidum and pertenue treponemes identified genes possibly involved in the high invasivity of syphilis Treponema pallidum treponemes. Genetic variability within syphilis strains is considered as the basis of syphilis molecular Treponema pallidum ssp. pertenue Treponema pallidum ssp. endemicum epidemiology with potential to detect more virulent strains, whereas genetic variability within a single Treponema paraluiscuniculi strain is related to its ability to elude the immune system of the host. -
86A1bedb377096cf412d7e5f593
Contents Gray..................................................................................... Section: Introduction and Diagnosis 1 Introduction to Skin Biology ̈ 1 2 Dermatologic Diagnosis ̈ 16 3 Other Diagnostic Methods ̈ 39 .....................................................................................Blue Section: Dermatologic Diseases 4 Viral Diseases ̈ 53 5 Bacterial Diseases ̈ 73 6 Fungal Diseases ̈ 106 7 Other Infectious Diseases ̈ 122 8 Sexually Transmitted Diseases ̈ 134 9 HIV Infection and AIDS ̈ 155 10 Allergic Diseases ̈ 166 11 Drug Reactions ̈ 179 12 Dermatitis ̈ 190 13 Collagen–Vascular Disorders ̈ 203 14 Autoimmune Bullous Diseases ̈ 229 15 Purpura and Vasculitis ̈ 245 16 Papulosquamous Disorders ̈ 262 17 Granulomatous and Necrobiotic Disorders ̈ 290 18 Dermatoses Caused by Physical and Chemical Agents ̈ 295 19 Metabolic Diseases ̈ 310 20 Pruritus and Prurigo ̈ 328 21 Genodermatoses ̈ 332 22 Disorders of Pigmentation ̈ 371 23 Melanocytic Tumors ̈ 384 24 Cysts and Epidermal Tumors ̈ 407 25 Adnexal Tumors ̈ 424 26 Soft Tissue Tumors ̈ 438 27 Other Cutaneous Tumors ̈ 465 28 Cutaneous Lymphomas and Leukemia ̈ 471 29 Paraneoplastic Disorders ̈ 485 30 Diseases of the Lips and Oral Mucosa ̈ 489 31 Diseases of the Hairs and Scalp ̈ 495 32 Diseases of the Nails ̈ 518 33 Disorders of Sweat Glands ̈ 528 34 Diseases of Sebaceous Glands ̈ 530 35 Diseases of Subcutaneous Fat ̈ 538 36 Anogenital Diseases ̈ 543 37 Phlebology ̈ 552 38 Occupational Dermatoses ̈ 565 39 Skin Diseases in Different Age Groups ̈ 569 40 Psychodermatology -
Distinguishing Venereal Syphilis from Other Treponemal Infections on the Human Skeleton Antoinette Elizabeth Fafara-Thompson University of Wisconsin-Milwaukee
University of Wisconsin Milwaukee UWM Digital Commons Theses and Dissertations December 2015 Distinguishing Venereal Syphilis from Other Treponemal Infections on the Human Skeleton Antoinette Elizabeth Fafara-Thompson University of Wisconsin-Milwaukee Follow this and additional works at: https://dc.uwm.edu/etd Part of the Biological and Physical Anthropology Commons Recommended Citation Fafara-Thompson, Antoinette Elizabeth, "Distinguishing Venereal Syphilis from Other Treponemal Infections on the Human Skeleton" (2015). Theses and Dissertations. 1030. https://dc.uwm.edu/etd/1030 This Thesis is brought to you for free and open access by UWM Digital Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of UWM Digital Commons. For more information, please contact [email protected]. DISTINGUISHING VENEREAL SYPHILIS FROM OTHER TREPONEMAL INFECTIONS ON THE HUMAN SKELETON by Antoinette E. Fafara-Thompson A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science in Anthropology at The University of Wisconsin - Milwaukee December 2015 ! DISTINGUISHING VENEREAL SYPHILIS FROM OTHER TREPONEMAL INFECTIONS ON THE HUMAN SKELETON by Antoinette E. Fafara-Thompson The University of Wisconsin - Milwaukee, 2015 Under the Supervision of Professor Fred Anapol The Treponemal diseases of yaws, endemic and venereal syphilis are capable of producing skeletal lesions during the late stages of infection. Due to the relatedness within the Treponema species all three diseases produce similar skeletal pathologies, making the classification of one specific treponemal disease versus another extremely difficult. This study investigates the skeletal pathologies associated with the treponemal infections of yaws, endemic and venereal syphilis in order to determine the skeletal lesions limited to only venereal syphilis. -
Pinta: Latin America's Forgotten Disease?
Am. J. Trop. Med. Hyg., 93(5), 2015, pp. 901–903 doi:10.4269/ajtmh.15-0329 Copyright © 2015 by The American Society of Tropical Medicine and Hygiene Perspective Piece Pinta: Latin America’s Forgotten Disease? Lola V. Stamm* Program in Infectious Diseases, Department of Epidemiology, Gillings School of Global Public Health, Hooker Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Abstract. Pinta is a neglected, chronic skin disease that was first described in the sixteenth century in Mexico. The World Health Organization lists 15 countries in Latin America where pinta was previously endemic. However, the current prevalence of pinta is unknown due to the lack of surveillance data. The etiological agent of pinta, Treponema carateum, cannot be distinguished morphologically or serologically from the not-yet-cultivable Treponema pallidum subspecies that cause venereal syphilis, yaws, and bejel. Although genomic sequencing has enabled the development of molecular techniques to differentiate the T. pallidum subspecies, comparable information is not available for T. carateum. Because of the influx of migrants and refugees from Latin America, U.S. physicians should consider pinta in the differential diagnosis of skin diseases in children and adolescents who come from areas where pinta was previously endemic and have a positive reaction in serological tests for syphilis. All stages of pinta are treatable with a single intramuscular injection of penicillin. The endemic treponematoses, pinta, yaws, and bejel, -
Microevolutionary Change in the Human Pathogenic Treponemes: an Alternative Hypothesis DON BROTHWELL Institute of Archaeology, London Wcl, England
INTERNATIONALJOURNAL OF SYSTEMATICBACTERIOLOGY, Jan. 1981, p. 82-87 Vol. 31, No. 1 0020-7713/81/010082-06$02.00 NOTES Microevolutionary Change in the Human Pathogenic Treponemes: an Alternative Hypothesis DON BROTHWELL Institute of Archaeology, London WCl, England Recent evidence from both archaeology and biology suggests that the taxonomy of the human pathogenic treponemes may be more complex than previously thought. An alternative evolutionary tree for the treponematoses is suggested. During the past 50 years there has been grow- dum, is involved. Hackett (9),on the other hand, ing interest in the ecology of the human patho- considers the same range of evidence and as a genic treponemes. Not only have they been clas- result supports the following classification: Tre- sified on clinical evidence into a number of spe- ponema pallidum Schaudinn (1905)-venereal cies, but also theories as to their evolution since and endemic syphilis, Treponema pertenue Cas- Pleistocene times have been put forward. Evi- tellani (1908)-yaws; “Treponema carateum” dence over the past decade, from both archae- Brumpt (1939)-pinta. (Note: Names in quota- ology and biology, now seems to demand a re- tion marks are not on the Approved Lists of consideration of the microevolution of trepo- Bacterial Names [Int. J. Syst. Bacteriol. 30:225- nemes (or “treponemata”) of this kind. 420, 19801.) A variant of the latter classification For perhaps three or four centuries, syphilis is suggested by Hardy (ll),who accepts that the has been a subject of considerable epidemologi- differences between endemic and veneral syph- cal and clinical interest (16). Since 1905 (20), ilis are equally deserving of specific (or subspe- when Treponema pallidum was incriminated as cific) distinction, and therefore he would seem the causative agent of syphilis, the taxonomy to accept “T. -
I. an Introduction to Yaws
Brit. J. vener. Dis. (1971) 47, 223 Br J Vener Dis: first published as 10.1136/sti.47.4.223 on 1 August 1971. Downloaded from Neuro-ophthalmological study of late yaws I. An introduction to yaws J. LAWTON SMITH From the Department of Ophthalmology, University of Miami School of Medicine, Miami, Florida, U.S.A. Three major forms of treponemal disease are found patchy distribution in hot and humid regions. in man: syphilis, due to Treponema pallidum; yaws, Dark-skinned children under 10 years of age who due to Treponema pertenue; and pinta, due to live in rural areas are more commonly involved. Treponema carateum. The spirochaetes that cause Poor hygiene and lack of personal cleanliness pre- these diseases are morphologically indistinguishable. dispose to the disease. The incidence is slightly higher Furthermore, the diseases cannot be differentiated in boys than girls, perhaps because of the higher by any known serological test or therapeutic criterion. incidence of skin abrasions in the former. The in- Only two ways are now known by which the trepone- fection is spread by direct contact, and also by soiled matoses can be differentiated: clothing and bedding. According to the literature, (1) Clinical criteria; yaws is not venereal and not hereditary. The disease (2) Experimental infection of laboratory animals or is divided into primary, secondary, and tertiarycopyright. human volunteers. stages, which are also designated initial, early, and The rising incidence of infectious syphilis in the late stages in the Hackett classification. Yaws is said to United States, the usefulness of the FTA-ABS test in involve only the skin, mucous membranes, bones, diagnosis of late 'seronegative' syphilis, and the detec- and joints, and visceral lesions are said not to occur.