MyMedR

von Tunzelmann EW

Journal of the Straits Medical Association, 1890;1:36-42.

Matched MeSH terms: Syphilis

Fulltext Clinical Profile and Visual Outcomes of Ocular Syphilis: A Five-year Review in Hospital Universiti Sains, Malaysia

Ghanimi Zamli AK, Irma Ngah NS, Chew-Ean T, Muhammed J, Wan Hitam WH, Hussein A, et al.

Cureus, 2019 Feb 05;11(2):e4015.

PMID: 31007973 DOI: 10.7759/cureus.4015

Introduction Ocular syphilis is a sight-threatening condition. It can occur at any stage of syphilis infection, which present either with acute inflammation during the primary, secondary, and early latent stages or with chronic inflammation during tertiary infection, affecting virtually every ocular structure. This study was to report on the clinical presentation of ocular syphilis that presented to eye clinic Hospital Universiti Sains Malaysia. Methodology This was a retrospective study where medical records of ocular syphilis patients who attended eye clinic in Hospital Universiti Sains Malaysia from January 2013 to June 2017 were reviewed. Results A total of 10 patients (13 eyes) with ocular syphilis were identified out of 106 cases that presented with ocular inflammation. The mean age of presentation was 69.8 ± 6.4 years and seven of them (70%) were female. All patients were Malay and human immunodeficiency virus (HIV) was negative. The ocular manifestations included panuveitis (four eyes, 30.8%), anterior uveitis (two eyes, 15.4%), posterior uveitis (seven eyes, 53.8%) and optic neuritis (two eyes, 15.4%). Seven (53.8%) eyes presented with visual acuity of worse than 6/60, five (38.5%) eyes had visual acuity between 6/15 to 6/60, and one (7.7%) eye had visual acuity of 6/12 or better. Nine patients received an intravenous benzylpenicillin regime and one patient received an intramuscular penicillin injection. Out of 13 eyes affected, 11 (84.6%) eyes had improved visual acuity of at least one Snellen line after treatment. Visual acuity of 6/12 or better increased to four (30.8%) eyes. Conclusions Posterior uveitis was the commonest presentation of ocular syphilis in HIV-negative patients. Early detection and treatment of ocular syphilis can result in resolution of inflammation and improvement of vision.

Matched MeSH terms: Syphilis

Hemorrhagic Descemet Membrane Detachment Following Syphilitic Interstitial Keratitis

Höllhumer R, Zairani Mz A, Watson S

Cornea, 2016 Sep;35(9):1255-6.

PMID: 27227396 DOI: 10.1097/ICO.0000000000000889

PURPOSE: Syphilitic interstitial keratitis is a stromal inflammatory disease with characteristic secondary vascularization. This case illustrates a late complication of hemorrhagic Descemet membrane detachment.

METHODS: Case report.

RESULTS: The patient presented with painless sudden visual loss and progressive shallowing of the anterior chamber caused by hemorrhagic Descemet membrane detachment. She had corneal neovascularization and a positive syphilis serology. Owing to the risk of pupil block glaucoma, the patient had surgical drainage of the blood via an ab externo approach.

CONCLUSIONS: This case illustrates a previously unreported complication of syphilitic interstitial keratitis. The patient recovered good visual acuity and had residual pigment deposits in the pre-Descemet interface.

Matched MeSH terms: Syphilis/diagnosis; Syphilis/microbiology*; Syphilis/therapy

Fulltext Syphilis in the military community

Supramaniam V

Med J Malaysia, 1980 Mar;34(3):248-53.

PMID: 7412665

288 notifications of syphilis in military personnel for 1974 to 1978 are analysed. 56 cases are primary and 232 are latent syphilis in service personnel and 13 in women and children. Antenatal screening detected 56 cases (0.9%) of syphilis. Only 24 cases among soldiers had confirmatory tests done. Treatment varied and some were inadequately treated, others overtreated and many with incorrect schedules. Intramuscular penicillin was the treatment of choice in 85% of cases. Follow-up of cases was inadequate. In all, it indicated a poor control programme for STD. A good programme is possible within the armed forces set-up and a number of measures are suggested.

Matched MeSH terms: Syphilis/drug therapy; Syphilis/prevention & control*

Yaws in Borneo, not connected with syphilis

Smith F

Lancet, 1894;144:910.

DOI: 10.1016/S0140-6736(02)02047-0

Matched MeSH terms: Syphilis

Fulltext Early congenital syphilis--a continuing problem in Malaysia

Lim CT, Koh MT, Sivanesaratnam V

Med J Malaysia, 1995 Jun;50(2):131-5.

PMID: 7565181

Between February 1990 and May 1993, 13 cases of early congenital syphilis (ECS) were managed in the Paediatrics Unit, University Hospital, Kuala Lumpur. Twelve mothers were unbooked with 10 inborn babies. Only one mother had antenatal booking at this hospital but she defaulted antenatal follow-up. Several risk factors associated with ECS were identified: inadequate or no prenatal care (5/13), failure to repeat a serological test for syphilis in the third trimester when it was tested negative at first booking (5/13), sexual promiscuity, substance abuse and a past history of contracting sexually transmitted disease. All 10 mothers who had their serological test repeated at delivery were found to have a positive VDRL and TPHA. Adequate antenatal care early referral of infected, expectant mothers for treatment, and a repeat serological test for syphilis could have prevented these cases of ECS.

Matched MeSH terms: Syphilis/epidemiology; Syphilis, Congenital/diagnosis; Syphilis, Congenital/epidemiology*; Syphilis, Congenital/therapy

Musculoskeletal lesions in yaws

Sengupta S

Clin Orthop Relat Res, 1985 Jan-Feb;?(192):193-8.

PMID: 3967422

Yaws, a spirochetal infection that is endemic in certain tropical countries, including Malaysia, may present with various orthopedic problems. As the condition is relatively unknown, diagnosis is often missed, which leads to poor management. There are initial, early, and late phases of the disease process. By involving skin, bone, and joints, yaws can produce deep ulcerations, joint deformities, and bone destruction. Within a ten-year period in Malaysia, 14 cases of serologically proven yaws have been treated for chronic ulcers, gross joint deformities, and pathologic fractures.

Matched MeSH terms: Syphilis/diagnosis

Heat inactivation of serum potentiates anti-cardiolipin antibody binding in ELISA

Cheng HM, Ngeow YF, Sam CK

J Immunol Methods, 1989 Nov 30;124(2):235-8.

PMID: 2600427

Heat treatment of sera at 56 degrees C for 30 min results in positive ELISA reactions for anti-cardiolipin antibody (aCL) in sera that had undetectable or low levels of aCL before heat inactivation. The positive, potentiated reactivity of the heated sera in the aCL ELISA could be inhibited with the cardiolipin antigen and was abolished by prior IgG depletion using staphylococcal protein A. The heat-potentiating effect of aCL binding in ELISA was evident in both normal human sera and clinical sera including sera from patients with systemic lupus erythematosus and syphilis.

Matched MeSH terms: Syphilis/immunology

THE VALUE AND MANAGEMENT OF PERSISTENT KAHN POSITIVE IN TREATED SYPHILIS

SAMBHI JS

Med J Malaysia, 1963 Sep;18:19-24.

PMID: 14064291

Matched MeSH terms: Syphilis*; Syphilis Serodiagnosis*; Syphilis, Congenital*; Syphilis, Latent*

Prevalence of sexually transmitted diseases among new female drug abusers in a rehabilitation centre

Nordin RB, Rahman Bin Isa A, Rusli Bin Abdullah M

Malays J Med Sci, 2001 Jul;8(2):9-13.

PMID: 22893754 MyJurnal

The prevalence of sexually transmitted diseases (STD) among female drug abusers was studied by screening 130 new inmates of a rehabilitation centre. Data was collected using a structured questionnaire, physical examination and specimen collection for laboratory investigation at the Community Medicine Clinic of HUSM. The majority (64.6%) were Malays and self-confessed sex workers (77.7%). A high prevalence of syphilis (50.8%), hepatitis B (52.2%), moniliasis (23.8%), trichomoniasis (19.2%) and gonococcal vaginitis (8.5%) was noted. More than half of them harbour 2 or more STDs. Six subjects, of whom 5 were Malays, were HIV positive. The evidence indicates that female drug abusers need a thorough screening for STD followed by an aggressive treatment regimen. Since the majority of them were born Muslims, they should have access to spiritual counselling and rehabilitation, stressing on repentance, and adopting a compassionate and forgiving approach.

Matched MeSH terms: Syphilis

An epidemiological study of syphilis and predictors of treatment failure in University Malaya Medical Centre

Mohamed AK, Raja IA, Rukumani DV

Med J Malaysia, 2020 05;75(3):199-203.

PMID: 32467532

INTRODUCTION: There are limited studies on the epidemiology of syphilis in Malaysia. In this study we describe the clinical features and treatment outcomes of patients with syphilis attending a tertiary referral university hospital.

METHODS: We retrospectively reviewed the case records of patients with positive serology findings for syphilis in University Malaya Medical Center (UMMC) from January 2010 to December 2015. Serological positivity was defined as having a positive rapid plasma reagin (RPR) or Venereal Disease Research Laboratory (VDRL) with a confirmatory positive Treponema pallidum particle agglutination assay (TPPA). Treatment outcomes were divided into two, success or failure. Demographic and clinical characteristics associated with predictors of treatment failure were assessed using statistical package for the social science (SPSS). This study also included a neurosyphilis descriptive sub-study.

RESULTS: There were 637 patients identified with positive syphilis serology, but 258 patients were excluded as they did not meet the inclusion criteria. 379 patients were then taken for the demographic study; 14 patients (3.7%) were treated for neurosyphilis; 170 patients with complete data were included. In all 42/170 (24.7%) failed treatment, 12/170 (7.1%) had reinfection and 116/170 (68.2%) had treatment success. A final number of 158 patients were then taken and analyzed for predictors of treatment failure after excluding the 12 reinfection patients. Only low baseline RPR (<1:16) was found to be significant on multivariate logistic regression analysis (p value: 0.007, 95% CI: 1.42, 9.21).

CONCLUSION: Most of the patients were HIV positive and from the MSM (Men who have sex with Men) population. Low baseline RPR titre is a predictor of treatment failure.

Matched MeSH terms: Syphilis/diagnosis; Syphilis/drug therapy; Syphilis/epidemiology*; Syphilis/physiopathology*; Syphilis Serodiagnosis

Fulltext Preventing sexually transmitted infections: back to basics

Rompalo A

J Clin Invest, 2011 Dec;121(12):4580-3.

PMID: 22133882 DOI: 10.1172/JCI61592

Sexually transmitted infections (STIs) have plagued humans for millennia and can result in chronic disease, pregnancy complications, infertility, and even death. Recent technological advances have led to a better understanding of the causative agents for these infections as well as aspects of their pathogenesis that might represent novel therapeutic targets. The articles in this Review Series provide excellent updates on the recent advances in understanding of the pathogenesis of some very important and persistent STIs and discuss the importance of considering each pathogen in the broader context of the environment of the individual who it infects.

Matched MeSH terms: Syphilis/diagnosis; Syphilis/prevention & control

The influence of syphilis in South Indian estate women on foetal and infant mortality

Reed JG

Journal of the Malaya Branch of the British Medical Association, 1940;4:288-94.

Matched MeSH terms: Syphilis; Syphilis Serodiagnosis

Fulltext Syphilis in pregnancy

Wahab AA, Ali UK, Mohammad M, Md Monoto EM, Rahman MM

Pak J Med Sci, 2015 4 17;31(1):217-9.

PMID: 25878647 DOI: 10.12669/pjms.311.5932

Syphilis in pregnancy remains an important medical condition due to its consequences. We present two cases of young pregnant women who were diagnosed syphilis during their antenatal visit. The first case was a 29-year-old Malay lady diagnosed with syphilis during the first trimester of pregnancy, while the second case was a 21-year-old Chinese lady diagnosed with syphilis during the third trimester of pregnancy. The diagnosis and management of the syphilis in pregnancy are discussed.

Matched MeSH terms: Syphilis

Immigrant Health Study. 3. Foreign workers' study microbiological investlgations. [Abstract]

Lam SK, Ng KP, Ngeow YF, Puthucheary SD

JUMMEC, 1998;3:61-62.

During the study period, a total of 241 foreign workers were examined. The countries represented were Indonesia (103), Bangladesh (133), Myanmar (I), Pakistan (3) and others (1). The specimens collected were blood (238) and stool samples (173). The tests conducted on blood samples were for syphilis by RPR and TPHA, HIV, Hepatitis B, and from stool samples, enteric pathogens such as Salirzoirella spp, Shigelln spp. and Vibrio clrolerne. Table I shows the type of tests performed on the various nationalities and Table 2 the results of testing. Of the 230 blood samples tested by RPWPHA, five were positive, one from Indonesia (1.09%) and four from Bangladesh (3.79%). There was only one sample of blood out of 238 tested which was HIV positive (0.42%) and this was in an Indonesian. Twenty three workers were found to be Hepatitis B antigen positive (9.66%), 10 out of 102 (9.80%) from Indonesia and 13 out of 131 from Bangladesh (9.92%). As for the entric bacterial pathogens, only six out of 173 stool samples tested were positive, five for Saliizoilella Spp. and one for Slligdla sp. Of the five positives for Salmonella, one was from Indonesia and four from Bangladesh. The single isolate of Shigella was from Pakistan. From this pretiniinary study, it is obvious that hepatitis B is the most important problem among the workers from Indonesia and Bangladesh. The second of importance is venereal disease and enteric bacteria among Bangladesh workers. The other three national groups are too small to be analyzed. It is interesting to note that although these workers are supposed to have been screened for venereal diseases, a number of them were still found to be positive. However, we are not certain that these might not have been acquired locally. There was only one case of HIV detected but if the foreign workers continue with their pronliscuous lifestyle they are likely to pick up other sexually transmitted diseases including HIV and chlamydia1 infections. For those who were found to be stool positive for enteric pathogens, it is important to determine whether they are food-handlers as they will prove a significant risk for the spread of infections. Originally, it was intended to test blood samples for hepatitis C and E markers since the incidence in foreign countries from which the workers come are higher. However, due to the shortage of the samples, this had to be deferred. In the light that hepatitis carriage rate is the highest for the microbes tested, it is important to include these two markers in future studies.

Matched MeSH terms: Syphilis

Fulltext Subclinical acquired syphilis masquerading as membranous glomerulonephritis

Soehardy Z, Hayati SN, Rozita M, Rohana AG, Halim AG, Norella K, et al.

Med J Malaysia, 2006 Oct;61(4):484-6.

PMID: 17243528 MyJurnal

Membranous glomerulonephritis (MGN) is one of the common forms of nephrotic syndrome in the adult population. The majority of MGN are idiopathic, but the secondary forms can be seen in the setting of autoimmune disease, neoplasia, infection and following exposure to certain therapeutic agents. Histologically, MGN is an immunologically mediated disease in which immune complexes deposit in the subepithelial space. Syphilis is a venereal disease that can also be acquired by exposure to infected blood. Untreated syphilis may progress and develop renal complications such as membranous glomerulonephritis (MGN) or diffuse endocapillary glomerulonephritis with or without crescent formation. Today, with increasing awareness of sexually transmitted diseases especially HIV infection coupled by the practice of protected sexual intercourse and advancement of medicine, we have seen fewer and fewer cases of acquired syphilis. Furthermore, majority will present with typical syphilitic symptoms of such as chancre, rash, fever and lymph node enlargement in which case the diagnosis is easily obtained. We are reporting a case of acquired syphilis masquerading as membranous glomerulonephritis without typical syphilitic symptoms.

Matched MeSH terms: Syphilis/diagnosis*

Fulltext Experiences in the diagnosis and prevention of mental retardation of environmental origin in Singapore

Paul FM

Med J Malaysia, 1982 Dec;37(4):357-61.

PMID: 6300621

Consideration. is gzven to the recognition and prevention of carious types of mental retardation due to hazards of environmental origin. Observations are presented on congenital syphilis, congenital toxoplasmosis, congenital rubella, Singapore kernicterus, Japanese B encephalitis, and tuberculous meningitis. Appropriate preventiue measures have resulted in a significant reduction in Singapore of these conditions, and hence in a decreased frequency of environmentally determined mental retardation. and related disabilities.

Matched MeSH terms: Syphilis, Congenital/complications

Seroreactivity to syphilis in Malaysian blood donors and expectant mothers

Jegathesan M, Fan YH, Ong KJ

Southeast Asian J. Trop. Med. Public Health, 1975 Sep;6(3):413-8.

PMID: 1241163

Seroreactivity to syphilis is high among Malaysian blood donors and expectant mothers indicating a high degree of treponemal infection. Further epidemiological studies are required to ascertain what proportion of these could be syphilis and what porportion yaws. Blood donors hava a higher reactivity rate than expectant mothers, the reasons probably being soical. The titres obtained in the VDRL test appear to have a relation to FTA-ABS reactivity although this is not to say treponematosis can be excluded on the basis of low titre VDRL results.

Matched MeSH terms: Syphilis/epidemiology*; Syphilis Serodiagnosis*

Chemotherapy in tropical diseases

Nocht PB

Malayan Medical Journal, 1931;6:38-42.

Matched MeSH terms: Syphilis

Serological screening for syphilis during pregnancy in a multiethnic Asian population

Goh TH, Ngeow YF

Asia Oceania J Obstet Gynaecol, 1989 Mar;15(1):67-70.

PMID: 2735843

Out of 14,841 women who were serologically examined for syphilis at the antenatal booking clinic, University Hospital, Kuala Lumpur in Malaysia, 1.78% were VDRL positive and 1.05% TPHA positive with significant differences between the Malays, Indians and Chinese. These rates are higher than published series and were attributed to childhood yaws infection among the Malays. As differentiation between yaws and syphilitic infection in the clinic is difficult, all TPHA-reactive women were treated as for syphilis. Congenital syphilis was not diagnosed in those women who had been effectively treated before delivery.

Matched MeSH terms: Syphilis/ethnology*; Syphilis Serodiagnosis*

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