A better definition of active syphilis infection

Chen, Yu‐Yan; Qiu, Xin-Hui; Zhang, Yafeng; Zhang, Qiao; Fan, Jin-Yi; Gao, Kun; Zhu, Xiao-Zhen; Chen, Fuyi; Yang, Tian‐Ci

doi:10.1016/j.cca.2015.01.040

Cited by 3 publications

(3 citation statements)

References 18 publications

(24 reference statements)

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“…For example, syphilis-specific IgM cn be detected as early as 2 weeks after infection, [ 2 ] nontreponemal antibodies can be detected 5 to 7 weeks after initial infection, and both of these are generally correlated with disease activity. [ 3 ] The rabbit infectivity test (RIT) is another method used to establish infection with viable Treponema pallidum , and it has historically been considered as the gold standard for detecting active syphilis. This method has a test sensitivity high enough to detect as few as a single organism when repeated passages are performed in rabbits.…”

Section: Introductionmentioning

confidence: 99%

A negative nontreponemal and/or specific antitreponemal IgM test does not exclude active infectious syphilis

Lin

Tong²,

Gao³

et al. 2016

Medicine

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Background:The diagnostic criteria for active infectious syphilis in the clinic are important matter of controversy and debate. So far, clinicians habitually do use the negative results of the nontreponemal and/or the specific antitreponemal IgM as the evidences of disease-free or active infection-free status.Method:We present a case study involving a patient who was admitted to Zhongshan Hospital because of cerebral infarct. Clinical examination indicated he had a history of latent syphilis with negative nontreponemal and specific antitreponemal IgM tests. The cerebrospinal fluid sample from the patient was inoculated into seronegative New Zealand rabbit.Results:Motile Treponema pallidum was detected by a rabbit infectivity test in the patient's cerebrospinal fluid. This syphilis strain was confirmed by DNA subtyping form of “centers for disease control subtype/tp0548 sequence type”, and the strain type was 14d/f. Treatment with benzathine penicillin provided no apparent benefit, but treatment with aqueous crystalline penicillin G, especially recommended for neurosyphilis, led to disease regression. No evidence of cerebral infarct was observed during a 2-year follow-up period.Conclusion:The definitive differential diagnosis of active infectious syphilis should be reconsidered. Moreover, selecting the appropriate penicillin preparation is important because T pallidum can reside in sequestered sites. It is necessary to treat a patient with known invasion of the central nervous system with aqueous crystalline penicillin G, if previous treatment for syphilis failed and patients had some clinical neurological presentation that is otherwise unexplained, but that could represent neurosyphilis. Additional studies are needed to confirm the results in other syphilis patients.

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Section: Introductionmentioning

confidence: 99%

A negative nontreponemal and/or specific antitreponemal IgM test does not exclude active infectious syphilis

Lin

Tong²,

Gao³

et al. 2016

Medicine

Self Cite

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“…Based on serological test results, syphilis seropositivity was divided into historical infection and active infection, which was consistent with the classification from previous studies 12. Historical infection was defined as TPPA positive but TRUST negative and active infection as both TPPA and TRUST positive 14. Syphilis seropositivity was defined as TPPA positive, including both TRUST negative and TRUST positive.…”

Section: Methodsmentioning

confidence: 74%

Association between syphilis seroprevalence and age among blood donors in Southern China: an observational study from 2014 to 2017

Wu¹,

Guan

Ye³

et al. 2019

BMJ Open

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ObjectiveThis study investigated the association between syphilis seroprevalence and age among blood donors, and described the distribution of serological titres among syphilis-infected donors, aiming to confirm the syphilis epidemic characteristics and to promote effective interventions for older adults.MethodsData were obtained from the Shenzhen Programme for Syphilis Prevention and Control in 2014–2017. Blood samples were screened using the ELISAs, and confirmed using the Treponema pallidum particle agglutination assay (TPPA) and toluidine red unheated serum test (TRUST).ResultsAmong 394 792 blood donors, 733 tested TPPA and TRUST positive (active infection), and 728 tested only TPPA positive (historical infection). The overall prevalence of syphilis seropositivity was 370.1 per 100 000 (95% CI 351.1 to 389.0 per 100 000); the prevalence of active infection was 185.7 per 100 000 (95% CI 172.2 to 199.1 per 100 000). People aged ≥45 years displayed a prevalence of 621.8 per 100 000 in syphilis seropositivity and 280.5 per 100 000 in active infection, which were 3.8 times and 2.4 times higher than that for people aged <25 years, respectively. The prevalence of syphilis seropositivity (χ2 trend=311.9, p trend<0.001) and active infection (χ2 trend=72.1, p trend<0.001) increased significantly with age. After stratification by gender and year of donation, the increasing trend of prevalence with age remained (p trend<0.05), except for the prevalence of active infection in males and females in 2014. About 16.3% of donors with active infection and aged ≥45 years had a TRUST titre of ≥1∶8, lower than that of patients aged <25 years (51.3%) and 25–34 years (34.1%).ConclusionsThe findings confirm the high prevalence of syphilis among older adults, and suggest the need to increase awareness among healthcare providers and deliver more targeted prevention interventions for older adults to promote early testing.

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“…Failure to accurately manage active syphilis infections can result in the progression of severe complications, including cardiovascular disease and central nervous system disorders. 18 Therefore, since patients with early latent syphilis are in the active syphilis infection stage, they should be better managed clinically to minimize the risk of syphilis transmission and to impede disease progression toward more severe manifestations. In accordance with the World Health Organization (WHO) guidelines for syphilis treatment, late latent syphilis necessitates prolonged antimicrobial therapy courses compared to early latent syphilis.…”

Section: Discussionmentioning

confidence: 99%

Advancing Precise Syphilis Diagnosis: A Nontreponemal IgM Antibody-Based Model for Latent Syphilis Staging

Xie,

Guo,

Zheng

et al. 2024

IDR

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A better definition of active syphilis infection

Cited by 3 publications

References 18 publications

A negative nontreponemal and/or specific antitreponemal IgM test does not exclude active infectious syphilis

A negative nontreponemal and/or specific antitreponemal IgM test does not exclude active infectious syphilis

Association between syphilis seroprevalence and age among blood donors in Southern China: an observational study from 2014 to 2017

Advancing Precise Syphilis Diagnosis: A Nontreponemal IgM Antibody-Based Model for Latent Syphilis Staging

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