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2.
Medicina (B Aires) ; 79(5): 415-418, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31671396

RESUMO

We present the case of a 62-year-old woman who consulted for fever (38°), stabbing thoracic pain (on one side), and pruritic skin lesions. She underwent peripheral blood tests, chest X-rays and CT. Her symptoms were interpreted as severe communityacquired pneumonia. After a treatment with antibiotics, her skin lesions persisted, and other symptoms were only partially relieved. A skin biopsy was performed, which revealed Treponema pallidum. Such finding was confirmed through positive serum VDRL and FTA-ABS tests. The patient received 4 doses of benzathine penicillin G with favorable evolution of skin lesions and improvement of radiological images.


Assuntos
Pneumopatias/microbiologia , Sífilis/complicações , Biópsia , Dermatite/microbiologia , Dermatite/patologia , Feminino , Humanos , Pneumopatias/diagnóstico por imagem , Pneumopatias/patologia , Pessoa de Meia-Idade , Radiografia Torácica , Sífilis/microbiologia , Tomografia Computadorizada por Raios X , Treponema pallidum/isolamento & purificação
3.
Afr Health Sci ; 19(2): 1858-1865, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656468

RESUMO

Background: A significant proportion of newborns in the developing countries are born with congenital anomalies. Objective: This study investigated congenital infections due to Rubella virus, Toxoplasma gondii, Treponema pallidum among presumed normal neonates from full term pregnant women in Mwanza, Tanzania. Methods: Sera from mothers were tested for Treponema pallidum and Toxoplasma gondii infection while newborns from mothers with acute infections were tested for T. pallidum and T. gondii, and all newborns were tested for Rubella IgM antibodies. Results: A total of 13/300 (4.3 %) mothers had T. pallidum antibodies with 3 of them having acute infection. Two (0.7 %) of the newborns from mothers with acute infection were confirmed to have congenital syphilis. Regarding toxoplasmosis, 92/300 (30.7 %) mothers were IgG seropositive and 7 had borderline positivity, with only 1/99 (1%) being IgM seropositive who delivered IgM seronegative neonate. Only 1/300 (0.3 %) newborn had rubella IgM antibodies indicating congenital rubella infection. Conclusion: Based on these results, it is estimated that in Mwanza city in every 100,000 live births about 300 and 600 newborns have congenital rubella and syphilis infections, respectively. Rubella virus and T. pallidum are likely to be among common causes of congenital infections in developing countries.


Assuntos
Complicações Infecciosas na Gravidez/epidemiologia , Vírus da Rubéola/imunologia , Rubéola (Sarampo Alemão)/congênito , Rubéola (Sarampo Alemão)/epidemiologia , Sífilis Congênita/epidemiologia , Toxoplasma/imunologia , Toxoplasmose Congênita/epidemiologia , Treponema pallidum/imunologia , Adolescente , Adulto , Anticorpos Antivirais/sangue , Estudos Transversais , Feminino , Sangue Fetal/imunologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/imunologia , Cuidado Pré-Natal , Prevalência , Rubéola (Sarampo Alemão)/diagnóstico , Vírus da Rubéola/isolamento & purificação , Estudos Soroepidemiológicos , Sífilis/complicações , Sífilis/epidemiologia , Sífilis Congênita/diagnóstico , Tanzânia/epidemiologia , Toxoplasma/isolamento & purificação , Toxoplasmose/complicações , Toxoplasmose/epidemiologia , Toxoplasmose Congênita/diagnóstico , Treponema pallidum/isolamento & purificação , População Urbana
5.
Future Microbiol ; 14: 1099-1108, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31512516

RESUMO

Aim: To describe the molecular types of Treponema pallidum and the proportion of macrolide and tetracycline resistance mutations in Barcelona. Materials & methods: Molecular type was determined using the Enhanced-CDC Typing system and antibiotic resistance was determined by sequencing the 23S and 16S rRNA genes. Results: A total of 183 patients were enrolled and 213 specimens (99 ulcers, 114 bloods) were collected. Sixty-two (70.5%) of 88 ulcers and 0 (0%) of bloods T. pallidum-DNA containing samples were fully typed. Up to 21 different strain types were identified (14d/g in 27.4%; 14f/g in 14.5%). Macrolide resistance mutations were present in 95% and tetracycline in 0%. Conclusion: Several different strains co-exist in Barcelona with a high proportion of macrolide resistance and absence of tetracycline resistance.


Assuntos
Farmacorresistência Bacteriana , Macrolídeos/farmacologia , Tipagem Molecular , Sífilis/epidemiologia , Tetraciclina/farmacologia , Treponema pallidum/classificação , Treponema pallidum/efeitos dos fármacos , Antibacterianos/farmacologia , DNA Bacteriano/genética , DNA Ribossômico/genética , Humanos , Mutação , Prevalência , Estudos Prospectivos , RNA Ribossômico 16S/genética , RNA Ribossômico 23S/genética , Análise de Sequência de DNA , Espanha/epidemiologia , Sífilis/microbiologia , Treponema pallidum/genética , Treponema pallidum/isolamento & purificação
7.
J Med Case Rep ; 13(1): 227, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31345262

RESUMO

BACKGROUND: Syphilis is a sexually transmitted bacterial infection of the spirochete, Treponema pallidum. While primary syphilis often involves genitalia, oral manifestations are observed in a subset of patients. These lesions are often associated with submandibular and cervical lymphadenopathy. This is a case report of a primary syphilitic lesion located on the hard palate of the oral cavity, with only a very few cases described previously. CASE PRESENTATION: We describe a rare case of syphilis in a 59-year-old African American man presenting with subjective fevers, chills, marked submental lymphadenopathy, a diffuse skin rash, and an ulcer of the hard palate. CONCLUSIONS: This case report demonstrates the importance of maintaining a high index of suspicion for syphilitic infection when a patient presents with nonspecific symptoms, a diffuse rash, and an oral lesion.


Assuntos
Úlceras Orais/etiologia , Sífilis/complicações , Idoso , Progressão da Doença , Exantema/etiologia , Humanos , Masculino , Palato Duro , Sífilis/diagnóstico , Sífilis/fisiopatologia , Treponema pallidum/isolamento & purificação
9.
Emerg Infect Dis ; 25(8): 1581-1583, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31310214

RESUMO

Bejel, an endemic treponematosis caused by infection with Treponema pallidum subspecies endemicum, has not been reported in eastern Asia and the Pacific region. We report local spread of bejel among men who have sex with men in Japan. Spread was complicated by venereal syphilis.


Assuntos
Homossexualidade Masculina , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Treponema pallidum , Infecções por Treponema/epidemiologia , Infecções por Treponema/microbiologia , Adulto , Genes Bacterianos , Humanos , Japão/epidemiologia , Masculino , Filogenia , Vigilância em Saúde Pública , Análise de Sequência de DNA , Treponema pallidum/classificação , Treponema pallidum/genética , Treponema pallidum/isolamento & purificação , Adulto Jovem
10.
Diagn Microbiol Infect Dis ; 95(1): 89-92, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31279583

RESUMO

Malignant syphilis (also known lues maligna) is a rare and severe variant of secondary syphilis. It is most commonly seen in patients who are infected with human immunodeficiency virus (HIV), and rarely, it can occur in immunocompetent individuals. The exact mechanism of the development of malignant syphilis is not clear. It could probably be associated with immunosuppression, inappropriate immune response of the host, or virulent strain of Treponema pallidum. Coexistence of immunosuppression and inappropriate immune response may predispose to develop malignant syphilis in HIV-infected patients with immune reconstitution inflammatory syndrome. Herein, we report the first case of malignant syphilis after adalimumab therapy for Crohn's disease due to bariatric surgery and discuss the underlying possible pathogenic mechanisms.


Assuntos
Adalimumab/efeitos adversos , Anti-Inflamatórios/efeitos adversos , Cirurgia Bariátrica/efeitos adversos , Doença de Crohn/etiologia , Sífilis/diagnóstico , Treponema pallidum/isolamento & purificação , Adalimumab/uso terapêutico , Adulto , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Doença de Crohn/tratamento farmacológico , Feminino , Humanos , Penicilina G Benzatina/uso terapêutico , Sífilis/tratamento farmacológico , Sífilis/etiologia , Sífilis/patologia , Resultado do Tratamento , Treponema pallidum/efeitos dos fármacos
11.
BMC Infect Dis ; 19(1): 598, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288744

RESUMO

BACKGROUND: In Japan and other countries, the number of patients with syphilis is increasing year by year. Recently, the cases of the pulmonary involvement in patients with secondary syphilis have been reported. However, it is still undetermined how to obtain a desirable specimen for a diagnosis of the pulmonary involvement, and how to treat it if not cured. CASE PRESENTATION: A 34-year-old man presented with cough and swelling of the right inguinal nodes. A physical examination revealed erythematous papular rash over the palms, soles and abdomen. A 4 cm mass in the right lower lobe of the lung was detected on computed tomography. He was diagnosed as having secondary syphilis, because he was tested positive for the rapid plasma reagin and Treponema pallidum hemagglutination assay. Amoxycillin and probenecid were orally administered for 2 weeks. Subsequently, rash and serological markers were improved, however, the lung mass remained unchanged in size. Transbronchial biopsy (TBB) confirmed the pulmonary involvement of syphilis using polymerase chain reaction techniques (tpp47- and polA-PCR). Furthermore, following surgical resection revealed the lung mass to be an abscess. CONCLUSIONS: To our knowledge, this is the first surgically treated case of a lung abscess caused by syphilis, which was diagnosed by PCR techniques in TBB. This report could propose a useful diagnostic method for the pulmonary involvement of syphilis.


Assuntos
Reação em Cadeia da Polimerase/métodos , Sífilis/diagnóstico , Adulto , Brônquios/microbiologia , Brônquios/patologia , Proteína C-Reativa/análise , DNA Bacteriano/isolamento & purificação , DNA Bacteriano/metabolismo , Humanos , Masculino , Sífilis/microbiologia , Tomografia Computadorizada por Raios X , Treponema pallidum/genética , Treponema pallidum/isolamento & purificação
12.
PLoS Negl Trop Dis ; 13(6): e0007463, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31216284

RESUMO

BACKGROUND: Pathogenic treponemes related to Treponema pallidum are both human (causing syphilis, yaws, bejel) and animal pathogens (infections of primates, venereal spirochetosis in rabbits). A set of 11 treponemal genome sequences including those of five Treponema pallidum ssp. pallidum (TPA) strains (Nichols, DAL-1, Mexico A, SS14, Chicago), four T. p. ssp. pertenue (TPE) strains (CDC-2, Gauthier, Samoa D, Fribourg-Blanc), one T. p. ssp. endemicum (TEN) strain (Bosnia A) and one strain (Cuniculi A) of Treponema paraluisleporidarum ecovar Cuniculus (TPeC) were tested for the presence of positively selected genes. METHODOLOGY/PRINCIPAL FINDINGS: A total of 1068 orthologous genes annotated in all 11 genomes were tested for the presence of positively selected genes using both site and branch-site models with CODEML (PAML package). Subsequent analyses with sequences obtained from 62 treponemal draft genomes were used for the identification of positively selected amino acid positions. Synthetic biotinylated peptides were designed to cover positively selected protein regions and these peptides were tested for reactivity with the patient's syphilis sera. Altogether, 22 positively selected genes were identified in the TP genomes and TPA sets of positively selected genes differed from TPE genes. While genetic variability among TPA strains was predominantly present in a number of genetic loci, genetic variability within TPE and TEN strains was distributed more equally along the chromosome. Several syphilitic sera were shown to react with some peptides derived from the protein sequences evolving under positive selection. CONCLUSIONS/SIGNIFICANCE: The syphilis-, yaws-, and bejel-causing strains differed relative to sets of positively selected genes. Most of the positively selected chromosomal loci were identified among the TPA treponemes. The local accumulation of genetic variability suggests that the diversification of TPA strains took place predominantly in a limited number of genomic regions compared to the more dispersed genetic diversity differentiating TPE and TEN strains. The identification of positively selected sites in tpr genes and genes encoding outer membrane proteins suggests their role during infection of human and animal hosts. The driving force for adaptive evolution at these loci thus appears to be the host immune response as supported by observed reactivity of syphilitic sera with some peptides derived from protein sequences showing adaptive evolution.


Assuntos
Adaptação Biológica , Genes Bacterianos , Genótipo , Sífilis/microbiologia , Sífilis/patologia , Treponema pallidum/classificação , Treponema pallidum/genética , Adulto , Genômica , Humanos , Seleção Genética , Treponema pallidum/isolamento & purificação , Adulto Jovem
14.
J Biosci ; 44(2)2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31180047

RESUMO

Syphilis is a sexually transmitted infection caused by Treponema pallidum, which is highly prevalent in several countries, including Brazil. The use of bioinformatics' tools for the identification of resistance genes is an important practice for the study of microorganisms, such as T. pallidum. In this study, the complete genomes of 43 strains of T. pallidum, isolated from different countries, were analyzed. A total of 41,514 sequences were obtained, and compared against prokaryote resistance gene databases using BLASTn, BLASTx and RGI for gene alignment and prediction. From the alignments, it was possible to identify antibiotic resistance genes for each strain. The genes identified in each comparison were grouped according to the antibiotic category in which they show resistance to. The antibiotic-resistant genes related to drugs used to treat syphilis were grouped separately. The in silico tools used have shown to be effective in identifying resistance genes in genomes of T. pallidum strains. Due to the lack of research and accurate information regarding the antibiotic resistance genes in T. pallidum, this study serves as a basis for studies in molecular biology whose aim is the identification of these genes, besides being a reference to help in the control and treatment of this infection.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla/genética , Genes Bacterianos , Sífilis/tratamento farmacológico , Treponema pallidum/genética , Sequência de Bases , Cefalosporinas/farmacologia , China/epidemiologia , Biologia Computacional/métodos , Humanos , Macrolídeos/farmacologia , Penicilinas/farmacologia , Portugal/epidemiologia , Alinhamento de Sequência , Sífilis/epidemiologia , Sífilis/microbiologia , Treponema pallidum/efeitos dos fármacos , Treponema pallidum/isolamento & purificação , Estados Unidos/epidemiologia
16.
BMC Infect Dis ; 19(1): 360, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31035953

RESUMO

BACKGROUND: Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. The disease affects all ages and both sexes but more prevalent among the sexually active age group of 15-49 years. The purpose of the current study was to determine the prevalence and factors associated with syphilis infection among outpatients 15-49 years in the Asikuma Odoben Brakwa District of Ghana where high levels of infection were earlier reported among antenatal women. METHODS: A descriptive cross-sectional study was carried out in 13 randomly selected health facilities. Blood samples were collected and tested for syphilis infection and a questionnaire administered to determine factors associated with the disease. RESULTS: A total 277 patients aged 15-49 years participated in the study. The overall prevalence of syphilis infection was 3.2% (9/277), with 5.7% (6/105) and 1.7% (3/172) among males and females respectively. Significant factors associated with syphilis infection included sub-district of residence, (χ2 (4) = 31.20, p < 0.001) and history of coerced sexual intercourse (χ2 (1) =7.49, p = 0.006). CONCLUSIONS: The prevalence of syphilis infection was high among male patients who lived in rural areas. Having a history of coerced sexual intercourse was a strong predictor for syphilis infection. Access to sexually transmitted infection control interventions in rural communities including health education may help control the disease.


Assuntos
Doenças Sexualmente Transmissíveis/diagnóstico , Sífilis/diagnóstico , Adolescente , Adulto , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pacientes Ambulatoriais , Prevalência , Comportamento Sexual , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/microbiologia , Sífilis/epidemiologia , Sífilis/microbiologia , Treponema pallidum/isolamento & purificação , Adulto Jovem
17.
Int J STD AIDS ; 30(7): 707-709, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31112488

RESUMO

An atypical early primary syphilis case presentation with multiple umbilicated papular lesions on the penis and a nonreactive syphilis serology was misdiagnosed as molluscum contagiosum. Over a period of eight weeks, prior to dermatologic consultation, the papules enlarged, ulcerated, and healed. New plaque and patch formation on the penis and scrotum led to a differential diagnosis of inverse psoriasis vs. syphilis. Histological examination of a shave biopsy specimen revealed numerous Treponema pallidum organisms and repeat syphilis serological test results confirmed a syphilis diagnosis. Lesions responded to treatment with benzathine penicillin. One must keep a high index of suspicion for syphilis in light of its diverse presentation and increasing incidence.


Assuntos
Doenças do Pênis/diagnóstico , Úlcera Cutânea/diagnóstico , Sífilis/diagnóstico , Treponema pallidum/isolamento & purificação , Biópsia , Cancro/microbiologia , Humanos , Masculino , Penicilina G Benzatina/uso terapêutico , Doenças do Pênis/tratamento farmacológico , Pênis/patologia , Escroto/patologia , Pele/patologia , Úlcera Cutânea/patologia , Sífilis/tratamento farmacológico , Adulto Jovem
18.
J Med Microbiol ; 68(5): 761-769, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30994442

RESUMO

PURPOSE: Syphilis, caused by Treponema pallidum subspecies pallidum , is considered as an old disease affecting humans; traces of such infections, including congenital syphilis, are potentially identifiable in archaeological samples. The aim of this research was to perform macroscopic and molecular investigations of T. pallidum on six infant remains, buried between 1837 and 1867, from the cemetery of 'Les Crottes' in Marseille city (southeastern France). METHODOLOGY: Pathological analysis of bones from individuals, aged from the twenty-ninth week of amenorrhea to 4-9 months, was performed. Samples served also as a source of ancient DNA (aDNA) for PCR-based molecular investigations targeting T. pallidum DNA; all samples were also tested for Mycobacterium tuberculosis and Plasmodium falciparum DNA. Sequences characterized were cloned and sequenced, and compared to those available in databases.Results/Key findings. All samples tested displayed widespread osteoporotic lesions across the skeleton possibly related to some metabolic or infectious disorders. Subsequent molecular analysis revealed that one individual, SP332 (unborn, 29 amenorrhea weeks, inhumation date 1864-1866), exhibited positive signals for the five T. pallidum amplification systems tested; sequence analysis provided strong evidence for the effective detection of T. pallidum subspecies pallidum DNA. CONCLUSIONS: Individual SP332 is the first PCR-confirmed palaeopathological case of syphilis identified in France, and the youngest specimen ever to be diagnosed with certainty for congenital syphilis. Future research aimed at better characterizing this 150-year-old treponeme genome and exploring new archaelogical cases of syphilis in the very young should contribute to a better comprehension of the disease's history.


Assuntos
DNA Antigo/isolamento & purificação , Sífilis Congênita/microbiologia , Treponema pallidum/isolamento & purificação , Arqueologia , Cemitérios , Feto/microbiologia , França , História do Século XIX , Humanos , Lactente , Mycobacterium tuberculosis/genética , Plasmodium falciparum/genética , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Sífilis Congênita/história , Treponema pallidum/classificação
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