Immunoperoxidase technique for detecting spirochetes in tissue sections: comparison with other methods

Phelps, Robert; Knispel, Jeffrey; Tu, Erik Schuman; Cernainu, Georgetta; Saruk, Michael

doi:10.1046/j.1365-4362.2000.00029.x

Cited by 47 publications

(42 citation statements)

References 13 publications

(16 reference statements)

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“…The intratissular location of T. pallidum has been studied using histochemical and, more recently, immunohistochemical procedures [3,16,17,18,19,20,21,22,25]. The present study confirms the epidermal and lichenoid patterns of distribution of T. pallidum .…”

Section: Discussionsupporting

confidence: 81%

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Perivascular Cuff and Spread of <i>Treponema pallidum</i>

Quatresooz

Pierard

2009

Dermatology

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Background: The incidence of syphilis is on the rise in many cities worldwide. Both the clinical and histopathological changes do not always fulfil the typical diagnostic criteria. Immunohistochemistry is available to identify and localize Treponema pallidum. Two main patterns of T. pallidum distribution were described in the skin, namely heavy intraepidermal infiltration and scattered pattern inside the lichenoid cell infiltrate. Objective: To search for a third pattern consistent with dissemination of the disease. Methods: Immunohistochemistry using an antispirochete (T. pallidum and Borrelia) antibody was used in all cases of syphilis submitted to our laboratory. In addition, deposits of immunoglobulins and complement indicative of immune complexes were searched for. Results: According to the cases, T. pallidum was disclosed in a combination of three patterns. The previously described epidermal and lichenoid patterns were confirmed, and a third pattern predominating in a perivascular location throughout the dermis was clearly identified in primary syphilis. The microorganisms were abundant in extracellular and intracellular locations, particularly inside endothelial cells. No deposits of immunoglobulins and complement were disclosed. Conclusion: The perivascular cuff of T. pallidum throughout the dermis might be representative of the dissemination phase of T. pallidum.

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Section: Discussionsupporting

confidence: 81%

“…Hence, in this field, there was a need for improving the diagnostic accuracy of skin biopsies. Immunohistochemistry using an antibody directed to T. pallidum was reported to improve the histological diagnostic accuracy of syphilis [4,16,17,18,19,20,21,22]. …”

Section: Introductionmentioning

confidence: 99%

Perivascular Cuff and Spread of <i>Treponema pallidum</i>

Quatresooz

Pierard

2009

Dermatology

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“…In addition, silver staining is reported to have low sensitivity in detecting spirochetes in the dermis compared to the immunohistochemical stain (17, 18). Previous reports have shown that immunohistological stain is more sensitive and specific than silver stain for detection (18,19). Furthermore, due to the near absence of background artifacts, rare dermal spirochetes could be visualized using this technique.…”

Section: Discussionmentioning

confidence: 90%

Pathologically Confirmed Malignant Syphilis in an HIV-Infected Patient

et al. 2011

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We report a case of pathologically confirmed malignant syphilis in an HIV-infected patient. Physical examinations revealed ulceronecrotic skin lesions. Skin biopsies demonstrated syphilis spirochetes on immunohistochemical stain, and syphilis serological titers were positive. Treatment with intravenous penicillin G was begun, and complete resolution of the skin lesions was observed. A rapid plasma reagin titer test performed 3 months after treatment revealed a 4-fold reduction in the titer, indicating successful treatment.

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“…Recently, immunoperoxidase techniques, using specific polyclonal antibodies against T pallidum, have been advocated as sensitive and useful methods to avoid background staining and facilitate the identification and visualization of spirochetes in paraffin-embedded tissues [3]. Theoretically, this technical approach may allow more precise defining of the different patterns of T pallidum spirochete distribution in skin and mucosal biopsy specimens.…”

Section: Introductionmentioning

confidence: 99%