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Molecular Typing of Treponema pallidum in Ocular Syphilis.

Authors
  • Oliver, Sara1
  • Sahi, Sharon K
  • Tantalo, Lauren C
  • Godornes, Charmie
  • Neblett Fanfair, Robyn
  • Markowitz, Lauri E
  • Lukehart, Sheila A
  • Marra, Christina M
  • 1 From the *Centers for Disease Control and Prevention, Atlanta, GA; †Department of Neurology, and ‡Department of Medicine (Infectious Diseases), University of Washington School of Medicine, Seattle, WA.
Type
Published Article
Journal
Sexually transmitted diseases
Publication Date
Aug 01, 2016
Volume
43
Issue
8
Pages
524–527
Identifiers
DOI: 10.1097/OLQ.0000000000000478
PMID: 27419819
Source
Medline
Language
English
License
Unknown

Abstract

Syphilis can have many clinical manifestations, including eye involvement, or "ocular syphilis." In 2015, an increase in reported cases of ocular syphilis and potential case clusters raised concern for an oculotropic strain of Treponema pallidum, the infectious agent of syphilis. Molecular typing was used to examine strains found in cases of ocular syphilis in the United States. In 2015, after a clinical advisory issued by the Centers for Disease Control and Prevention, pretreatment clinical specimens from US patients with ocular syphilis were sent to a research laboratory for molecular analysis of T. pallidum DNA. Molecular typing was conducted on these specimens, and results were compared with samples collected from Seattle patients diagnosed with syphilis, but without ocular symptoms. Samples were typed from 18 patients with ocular syphilis and from 45 patients with syphilis, but without ocular symptoms. Clinical data were available for 14 ocular syphilis patients: most were men, human immunodeficiency virus-infected, and had early syphilis. At least 5 distinct strain types of Treponema pallidum were identified in these patients, and 9 types were identified in the Seattle nonocular patients. 14d/g was the most common type in both groups. An unusual strain type was detected in a small cluster of ocular syphilis patients in Seattle. Ocular syphilis is a serious sequela of syphilis. In this preliminary study, clear evidence of a predominant oculotropic strain causing ocular syphilis was not detected. Identification of cases and prompt treatment is critical in the management of ocular syphilis.

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