AN INTRACELLULAR PARASITE DEVELOPING INTO SPIROCHAETES, Found by the Jelly Method of in Vitro Staining in Syphilitic Lesions and in the Circulating Blood During the Secondary Stages of the Disease

Ross, Edward Halford

doi:10.1136/bmj.2.2711.1651

Cited by 16 publications

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“…A similar pattern of intracellular T. pallidum infection within macrophages and aggregate structures was previously recognized in specimens from secondary and tertiary syphilitic patients. 52 Furthermore, in murine models, Bb rapidly gains entrance into macrophages through phagocytosis, normally resulting in degradation. However, Bb may survive phagocytosis and persist intracellularly, and infection within macrophages may provide a pathogenic mechanism.…”

Section: Histopathology Of MD Lesionsmentioning

confidence: 99%

<p>Classification and Staging of Morgellons Disease: Lessons from Syphilis</p>

Middelveen

Martinez²,

Fesler

et al. 2020

CCID

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Introduction: Morgellons disease (MD) is a contested dermopathy that is associated with Borrelia spirochetal infection. A simple classification system was previously established to help validate the disease based on clinical features (classes I-IV). Methods: Drawing on historical and pathological parallels with syphilis, we formulated a more detailed staging system based on clinical features as well as severity of skin lesions and corresponding histopathological infection patterns, as determined by anti-Borrelia immunohistochemical staining. Results: Clinical classes I-IV of MD are further categorized as mild, moderate and severe, or stages A, B and C, respectively, based on histopathological findings. Stage A lesions demonstrated little or no immune infiltrates and little or no disorganization of cells; macrophages were not present, and hemorrhage was negligible. Extracellular isolated spirochetes and intracellular staining of keratinocytes in the lower epidermis was occasionally seen. Stage C lesions demonstrated positive staining of keratinocytes in the stratum basale and stratum spinosum and positive intracellular staining of macrophages for Borrelia. Aggregate Borrelia colonies were frequently encountered, hemorrhage was frequent, and intracellularly stained fibroblasts were occasionally seen. Stage B lesions demonstrated a pattern intermediate between Stages A and C. Conclusion: The enhanced staging system provides objective criteria to assess the severity of dermopathy in MD. Further studies are needed to determine the optimal treatment for MD based on this staging system related to Borrelia infection.

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Section: Histopathology Of MD Lesionsmentioning

confidence: 99%