PCR testing for<i>Treponema pallidum</i>in paraffin-embedded skin biopsy specimens: test design and impact on the diagnosis of syphilis

Behrhof, Wera; Springer, Erik; Bräuninger, Wolfgang; Kirkpatrick, Charles James; Weber, Achim

doi:10.1136/jcp.2007.046714

Cited by 59 publications

(41 citation statements)

References 19 publications

(19 reference statements)

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“…Therefore, further studies with clinical specimens are required to clarify this issue. Some investigators have used biopsy specimens from skin lesions with various rates of success for the diagnosis of syphilis by PCR (75% of 12 specimens in one study and 39% of 36 specimens in another) (3,5). The use of skin biopsy specimens for diagnostic purposes is limited in most clinical settings.…”

Section: Discussionmentioning

confidence: 99%

Molecular Characterization of Syphilis in Patients in Canada: Azithromycin Resistance and Detection of Treponema pallidum DNA in Whole-Blood Samples versus Ulcerative Swabs

et al. 2009

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Although detection of Treponema pallidum DNA in whole-blood specimens of syphilis patients has been reported, it is uncertain at what stage of the disease such specimens are most suitable for the molecular diagnosis of syphilis. Also, few studies have directly compared the different gene targets for routine laboratory diagnostic usage in PCR assays. We examined 87 specimens from 68 patients attending two urban sexually transmitted disease clinics in Alberta, Canada. PCR was used to amplify the T. pallidum tpp47, bmp, and polA genes as well as a specific region of the 23S rRNA gene linked to macrolide antibiotic susceptibility. In primary syphilis cases, PCR was positive exclusively (75% sensitivity rate) in ulcerative swabs but not in blood specimens, while in secondary syphilis cases, 50% of the blood specimens were positive by PCR. Four out of 14 (28.6%) of our PCR-positive syphilis cases were found to be caused by an azithromycin-resistant strain(s). Our results confirmed that swabs from primary ulcers are the specimens of choice for laboratory diagnostic purposes. However, further research is required to determine what specimen(s) would be most appropriate for molecular investigation of syphilis in secondary and latent syphilis.

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Section: Discussionmentioning

confidence: 99%

Molecular Characterization of Syphilis in Patients in Canada: Azithromycin Resistance and Detection of Treponema pallidum DNA in Whole-Blood Samples versus Ulcerative Swabs

et al. 2009

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“…Since the early 2000s, the T. pallidum subsp. pallidum polA gene (TP0105) has been widely used as a target for detection of the syphilis agent according to the protocols of Liu et al (204) and Behrhorf et al (214). Several examples of quantitative amplification tests targeting polA are also available (215)(216)(217)).…”

Section: Direct Detection Methodsmentioning

confidence: 99%

The Endemic Treponematoses

2014

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SUMMARY The agents of human treponematoses include four closely related members of the genus Treponema : three subspecies of Treponema pallidum plus Treponema carateum . T. pallidum subsp. pallidum causes venereal syphilis, while T. pallidum subsp. pertenue , T. pallidum subsp. endemicum , and T. carateum are the agents of the endemic treponematoses yaws, bejel (or endemic syphilis), and pinta, respectively. All human treponematoses share remarkable similarities in pathogenesis and clinical manifestations, consistent with the high genetic and antigenic relatedness of their etiological agents. Distinctive features have been identified in terms of age of acquisition, most common mode of transmission, and capacity for invasion of the central nervous system and fetus, although the accuracy of these purported differences is debated among investigators and no biological basis for these differences has been identified to date. In 2012, the World Health Organization (WHO) officially set a goal for yaws eradication by 2020. This challenging but potentially feasible endeavor is favored by the adoption of oral azithromycin for mass treatment and the currently focused distribution of yaws and endemic treponematoses and has revived global interest in these fascinating diseases and their causative agents.

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“…Laboratory tests disclosed a white blood cell count of 6,800/ mm 3 with 3% eosinophils, hemoglobin level of 11.6 g/dl, platelet count of 397,000/mm 3 , and C-reactive-protein level of 1.69 mg/dl. Serum creatinine and electrolyte levels and tests of liver function were normal.…”

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confidence: 99%

“…Another useful ancillary tool in the diagnosis of syphilis is PCR. PCR can detect fewer organisms and can be complementary to immunohistocheminal staining in identifying T. pallidum from skin biopsy specimens (3,9).…”

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confidence: 99%

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Erythema Multiforme Caused by Treponema pallidum in a Young Patient with Human Immunodeficiency Virus Infection

Chiang

Chang

et al. 2010

J Clin Microbiol

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Erythema multiforme (EM) is usually caused by drug reactions or virus infection.We report a case of secondary syphilis presenting as EM in an HIV-infected patient, proved by immunohistochemical staining, which is rare in the literature. It is valuable to determine the etiology of EM to optimize treatment. CASE REPORTA 26-year-old homosexual man presented to our hospital with a 5-day history of fever episodes and pruritic skin rashes all over. The lesions had initially developed on his upper limbs and then extended to the entire body. He had been healthy except for one episode of chronic diarrhea due to Giardia infection that was completely treated 2 months previously and one episode of a perioral herpetic ulcer more than 6 months previously. He had no history of drug use before the occurrence of skin eruptions.He was well oriented. His body temperature was 37.6°C, blood pressure was 128/66 mm Hg, pulse was 83 per minute, and respiratory rate was 18 per minute. On physical examination, there were numerous discrete, coin-sized annular erythemas with central dusky red areas (target lesions) over his four limbs, trunk, head, and neck (Fig.

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PCR testing forTreponema pallidumin paraffin-embedded skin biopsy specimens: test design and impact on the diagnosis of syphilis

Cited by 59 publications

References 19 publications

Molecular Characterization of Syphilis in Patients in Canada: Azithromycin Resistance and Detection of Treponema pallidum DNA in Whole-Blood Samples versus Ulcerative Swabs

Molecular Characterization of Syphilis in Patients in Canada: Azithromycin Resistance and Detection of Treponema pallidum DNA in Whole-Blood Samples versus Ulcerative Swabs

The Endemic Treponematoses

Erythema Multiforme Caused by Treponema pallidum in a Young Patient with Human Immunodeficiency Virus Infection

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