Syphilis on the rise: A series of 12 cases with mucocutaneous features over a short span

Rajakumari, Suganthy; Mohan, Nithya; T, Amul Prathap

doi:10.25259/ijdvl_880_18

IJDVL

2021

DOI: 10.25259/ijdvl_880_18

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Syphilis on the rise: A series of 12 cases with mucocutaneous features over a short span

Suganthy Rajakumari¹,

Nithya Mohan²,

Amul Prathap T³

Abstract: This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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“…However, several case series have reported tender chancres, single or multiple, without evidence of coinfections with herpes simplex virus (HSV) or other infectious agents known to cause pain. These painful lesions were attributed to syphilis based on T. pallidum polymerase chain reaction (PCR) testing of the lesions [2][3][4][5] or detection of T. pallidum by immunohistochemistry. 6 It is reasonable to raise the question of whether the painful chancre phenotype is due to infection caused by a particular strain (or strains) of T. pallidum.…”

mentioning

confidence: 99%

A Novel Treponema pallidum Subspecies pallidum Strain Associated With a Painful Oral Lesion Is a Member of a Potentially Emerging Nichols-Related Subgroup

Velasquez,

De Lay,

Edmondson

et al. 2024

Sexual Trans Dis

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Background Early syphilitic lesions are typically painless; however, several recent case studies have included patients with tender lesions and no evidence of concurrent infections. Here we present the manifestations and serological and molecular findings of a patient from New York State with a painful tongue lesion. Methods The diagnosis of syphilis was based on a combination of physical examination, serologic, pathologic, and immunohistochemical findings. DNA obtained from a formalin fixed paraffin embedded (FFPE) biopsy was used to characterize the infecting pathogen using PCR, multilocus sequence typing (MLST), and whole genome sequencing (WGS) methods. Results PCR and MLST of the biopsy specimen confirmed infection with Treponema pallidum subsp. pallidum (T. pallidum) of the Nichols cluster. WGS analysis of this strain (herein called NYMC01) showed that it contained 17 unique single nucleotide variations and 4 more complex genetic differences; this novel genotype matched only two specimens, both from a patient in Seattle, Washington, U.S.A. The presence of this rare genotype in two geographically distinct locations suggests the potential emergence and spread of a new subgroup of the Nichols cluster. Conclusions To our knowledge, this is the first genomic sequence obtained from a T. pallidum strain linked to a painful lesion, and the third description of whole genome sequencing of T. pallidum from FFPE tissue. Analysis of additional specimens may reveal that the NYMC01-related genotype represents an emerging T. pallidum subgroup and may also aid in determining whether the painful clinical presentation of primary syphilis is related to specific T. pallidum genotypes.

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mentioning

confidence: 99%

A Novel Treponema pallidum Subspecies pallidum Strain Associated With a Painful Oral Lesion Is a Member of a Potentially Emerging Nichols-Related Subgroup

Velasquez,

De Lay,

Edmondson

et al. 2024

Sexual Trans Dis

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Syphilis reactivity in blood donors and their response rate – A study from 'Westernized” Western India and the need of the hour for a structured screening methodology

Augustine

Mahambare

Mallya

et al. 2022

Glob J Transfus Med

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The Changing Trend of Syphilis

Gupta,

Verma,

Sharma

et al. 2023

Indian Journal of Dermatology

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Background: Syphilis is a treatable bacterial infection caused by Treponema pallidum. There has been a change in incidence of syphilis in various nations over the years. Aim: To study the epidemiological trends, demographic profile, high-risk behaviour, clinical pattern, and stage of syphilis over the last ten years in patients presenting to an STD clinic in a tertiary care hospital. Material and Methods: This was a retrospective observational study over ten years. Records of all confirmed syphilis cases were analysed in relation to demography and clinical profile. Results: There were a total of 3,110 STD patients among whom 31 cases (accounting for 0.99%) of confirmed syphilis were seen. There was a significant increase in cases in the last five years of study, especially in the last year. An increase in primary (PS) and secondary syphilis (SS) was observed. Males outnumbered females (3:1). Mean age of patients was 35.0 ± 11.53 years. Professionals were most common (22.6%) having syphilis followed by farmers (19.35%). A significant proportion (45.1%) of our patients were at least graduates. Unprotected sex was seen in all the patients followed by extramarital/premarital sex (71.35%). There were 16.12% of cases who had a history of paid sex and 9.7% were homosexuals. SS and latent syphilis were more common (38.7% each) than PS (19.35%). In PS single chancre and in SS truncal asymptomatic rash was the commonest clinical presentation. Limitation: Single-centre study, including only self-reported patients leading to a small sample size, is the major limitation of the study. Conclusion: The increased trend of primary and secondary syphilis in recent years highlights that there is a risk of an impending epidemic.

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Syphilis on the rise: A series of 12 cases with mucocutaneous features over a short span

Cited by 3 publications

References 0 publications

A Novel Treponema pallidum Subspecies pallidum Strain Associated With a Painful Oral Lesion Is a Member of a Potentially Emerging Nichols-Related Subgroup

A Novel Treponema pallidum Subspecies pallidum Strain Associated With a Painful Oral Lesion Is a Member of a Potentially Emerging Nichols-Related Subgroup

Syphilis reactivity in blood donors and their response rate – A study from 'Westernized” Western India and the need of the hour for a structured screening methodology

The Changing Trend of Syphilis

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