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Molecular detection of Treponema pallidum in secondary and tertiary syphilis.
Br J Dermatol. 1997 May; 136(5):683-6.BJ

Abstract

Treponema pallidum can be detected by conventional techniques such as dark-field microscopy, immunofluorescence or the rabbit infectivity test, in large numbers in the skin lesions of primary and early secondary syphilis. In the skin lesions of late secondary and tertiary syphilis, conventional techniques fail to detect spirochaetes in general, perhaps due to increasing degeneration and the disappearance of treponemal spirochaetes in late syphilitic skin lesions. We used the highly sensitive technique of polymerase chain reaction (PCR) to prove the presence of Treponema pallidum-specific DNA in six lesions of late secondary syphilis and seven lesions of tertiary syphilis, including one syphilitic gumma. A Whartin-Starry stain was carried out in all 13 specimens and did not reveal any treponemal structures. Treponema pallidum-specific DNA was amplified by PCR in four of six cases of secondary syphilis and in the syphilitic gumma. These results are in favour of a direct cell-mediated immune reaction directed against treponemal antigen rather than the concept of an Id-reaction. Beside the usefulness of a PCR-based assay for understanding the aetiology of lesions of late syphilis, the assay described can be of clinical importance in various situations where traditional methods fail to detect Treponema pallidum because of lack of sensitivity.

Authors+Show Affiliations

Department of Dermatology, University of Graz, Austria.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9205499

Citation

Zoechling, N, et al. "Molecular Detection of Treponema Pallidum in Secondary and Tertiary Syphilis." The British Journal of Dermatology, vol. 136, no. 5, 1997, pp. 683-6.
Zoechling N, Schluepen EM, Soyer HP, et al. Molecular detection of Treponema pallidum in secondary and tertiary syphilis. Br J Dermatol. 1997;136(5):683-6.
Zoechling, N., Schluepen, E. M., Soyer, H. P., Kerl, H., & Volkenandt, M. (1997). Molecular detection of Treponema pallidum in secondary and tertiary syphilis. The British Journal of Dermatology, 136(5), 683-6.
Zoechling N, et al. Molecular Detection of Treponema Pallidum in Secondary and Tertiary Syphilis. Br J Dermatol. 1997;136(5):683-6. PubMed PMID: 9205499.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Molecular detection of Treponema pallidum in secondary and tertiary syphilis. AU - Zoechling,N, AU - Schluepen,E M, AU - Soyer,H P, AU - Kerl,H, AU - Volkenandt,M, PY - 1997/5/1/pubmed PY - 1997/5/1/medline PY - 1997/5/1/entrez SP - 683 EP - 6 JF - The British journal of dermatology JO - Br J Dermatol VL - 136 IS - 5 N2 - Treponema pallidum can be detected by conventional techniques such as dark-field microscopy, immunofluorescence or the rabbit infectivity test, in large numbers in the skin lesions of primary and early secondary syphilis. In the skin lesions of late secondary and tertiary syphilis, conventional techniques fail to detect spirochaetes in general, perhaps due to increasing degeneration and the disappearance of treponemal spirochaetes in late syphilitic skin lesions. We used the highly sensitive technique of polymerase chain reaction (PCR) to prove the presence of Treponema pallidum-specific DNA in six lesions of late secondary syphilis and seven lesions of tertiary syphilis, including one syphilitic gumma. A Whartin-Starry stain was carried out in all 13 specimens and did not reveal any treponemal structures. Treponema pallidum-specific DNA was amplified by PCR in four of six cases of secondary syphilis and in the syphilitic gumma. These results are in favour of a direct cell-mediated immune reaction directed against treponemal antigen rather than the concept of an Id-reaction. Beside the usefulness of a PCR-based assay for understanding the aetiology of lesions of late syphilis, the assay described can be of clinical importance in various situations where traditional methods fail to detect Treponema pallidum because of lack of sensitivity. SN - 0007-0963 UR - https://www.unboundmedicine.com/medline/citation/9205499/Molecular_detection_of_Treponema_pallidum_in_secondary_and_tertiary_syphilis_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0007-0963&date=1997&volume=136&issue=5&spage=683 DB - PRIME DP - Unbound Medicine ER -