MyMedR

Displaying all 6 publications

Abstract:

Sort:

Fulltext Neurosyphilis presenting as acute ischemic stroke

Krishnan D, Zaini SS, Latif KA, Joseph JP

Clin Med (Lond), 2020 Jan;20(1):95-97.
PMID: 31941739 DOI: 10.7861/clinmed.2019-0368

Neurosyphilis is a broad term used to describe an infection caused by Treponema pallidum in the central nervous system. While this was a common cause of stroke in the 19th century, it saw a decline after the introduction of penicillin. However, in the recent past, there has been an increase in the incidence of syphilis, especially with HIV coinfection. Neurosyphilis results from an untreated primary syphilis. Neuropsychiatric disorder appears to be the commonest manifestation followed cerebrovascular accident, myelopathy, ocular disease and seizure. Known as the 'great imitator', this entity, however, may be easily missed if not for a high index of suspicion. This is especially so because of its similar presentation to other more common clinical conditions. We describe the case of a 39-year-old man displaying acute global aphasia and right-sided facial weakness in keeping with a left middle cerebral artery infarct. This was confirmed with computed tomography of the brain, and subsequently, further investigations revealed a diagnosis of neurosyphilis. The patient was treated with intravenous benzylpenicillin and recovered well with treatment.

Matched MeSH terms: Treponema pallidum
Cerebral syphilis with a description of two interesting cases

Kanagarayer K

Malayan Medical Journal, 1928;3:15-6.

Matched MeSH terms: Treponema pallidum
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: Treponema pallidum/isolation & purification
Fulltext Evaluation of Elecsys Syphilis Assay for Routine and Blood Screening and Detection of Early Infection

Kremastinou J, Polymerou V, Lavranos D, Aranda Arrufat A, Harwood J, Martínez Lorenzo MJ, et al.

J Clin Microbiol, 2016 09;54(9):2330-6.
PMID: 27358468 DOI: 10.1128/JCM.02544-15

Treponema pallidum infections can have severe complications if not diagnosed and treated at an early stage. Screening and diagnosis of syphilis require assays with high specificity and sensitivity. The Elecsys Syphilis assay is an automated treponemal immunoassay for the detection of antibodies against T. pallidum The performance of this assay was investigated previously in a multicenter study. The current study expands on that evaluation in a variety of diagnostic settings and patient populations, at seven independent laboratories. The samples included routine diagnostic samples, blood donation samples, samples from patients with confirmed HIV infections, samples from living organ or bone marrow donors, and banked samples, including samples previously confirmed as syphilis positive. This study also investigated the seroconversion sensitivity of the assay. With a total of 1,965 syphilis-negative routine diagnostic samples and 5,792 syphilis-negative samples collected from blood donations, the Elecsys Syphilis assay had specificity values of 99.85% and 99.86%, respectively. With 333 samples previously identified as syphilis positive, the sensitivity was 100% regardless of disease stage. The assay also showed 100% sensitivity and specificity with samples from 69 patients coinfected with HIV. The Elecsys Syphilis assay detected infection in the same bleed or earlier, compared with comparator assays, in a set of sequential samples from a patient with primary syphilis. In archived serial blood samples collected from 14 patients with direct diagnoses of primary syphilis, the Elecsys Syphilis assay detected T. pallidum antibodies for 3 patients for whom antibodies were not detected with the Architect Syphilis TP assay, indicating a trend for earlier detection of infection, which may have the potential to shorten the time between infection and reactive screening test results.

Matched MeSH terms: Treponema pallidum/isolation & purification*
Fulltext Facial lesions resembling leprosy

Mohamed KB

Int. J. Lepr. Other Mycobact. Dis., 2001 Mar;69(1):35-7.
PMID: 11480315
Matched MeSH terms: Treponema pallidum/immunology
Fulltext Malaysia’s success in eliminating mother-to-child transmission of HIV and syphilis

Mohd Nasir Abd Aziz

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):24-24.
MyJurnal

Introduction: HIV and syphilis testing has been part of Malaysia’s comprehensive maternal & child health pro-gramme for more than 2 decades. Part of this antenatal package include lifelong antiretroviral (ARV) treatment to HIV+ pregnant women, free antiretroviral therapy (ART) prophylaxis/ infant formula for all HIV-exposed infants and appropriate management for syphilis positive antenatal mothers. The objective of this paper is to present the analysis of Malaysia’s achievement in obtaining the elimination of mother-to-child transmission of HIV (eMTCT) and syphilis status from the World Health Organisation (WHO). Methods: This survey is based on our surveillance and analysis of data on HIV and syphilis testing on pregnant women over a three-year period, beginning from 2015. Results: Malaysia’s national health survey revealed 97.4% of pregnant women in Malaysia had a minimum of four antenatal visits. The MOH’s surveillance system also showed 95.1% and 95.8% of pregnant women received HIV/ syphilis screening in 2015 and 2016 respectively, whilst the HIV vertical transmission rate declined from 16.12% in 2000 to 2.46% and 1.99% in 2015 and 2016 respectively. Congenital syphilis rates declined from 6.0 / 100,000 live births in 2012 to 5.0 and 4.0/ 100,000 live births in 2015 and 2016 respectively. In addition, more than 95% of antenatal mothers living with HIV received ARV and almost 100% of TPHA positive (Treponema pallidum haemagglutination) of expectant mothers received appropriate treatment. Conclusion: Based on such impressive findings, Malaysia was recognised by WHO in May 2018 as the first country in the Western Pacific Region to have successfully “eliminated” a significant public health problem.

Matched MeSH terms: Treponema pallidum