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Volume 29, Number 10—October 2023
Research

Treponema pallidum Detection at Asymptomatic Oral, Anal, and Vaginal Sites in Adults Reporting Sexual Contact with Persons with Syphilis

Ei T. AungComments to Author , Christopher K. Fairley, Deborah A. Williamson, Francesca Azzato, Janet M. Towns, Rebecca Wigan, Eric P.F. Chow1, and Marcus Y. Chen1
Author affiliations: Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia (E.T. Aung, C.K. Fairley, J.M. Towns, R. Wigan, E.P.F. Chow, M.Y. Chen); Central Clinical School, Monash University, Melbourne (E.T. Aung, C.K. Fairley, J.M. Towns, E.P.F. Chow, M.Y. Chen); The Doherty Institute for Infection and Immunity, Melbourne (D.A. Williamson); Victorian Infectious Diseases Reference Laboratory, Melbourne (D.A. Williamson, F. Azzato); Melbourne School of Population and Global Health, The University of Melbourne, Melbourne (E.P.F. Chow)

Main Article

Table 3

Characteristics of 10 syphilis patients with signs and symptoms of syphilis who had a positive serologic test and Treponema pallidum PCR detection from mucosal sites or lesion sites in retrospective study of patients who visited the Melbourne Sexual Health Centre, Melbourne, Victoria, Australia, during November 2018–March 2020*

Group by sexual practice HIV/PrEP status Signs on examination Mucosal PCR sites (value if positive†)
 Serologic test results
 Previous serologic test results (RPR titer if reactive) Staging of syphilis
Oral cavity Vagina Anus Lesion PCR sites (value if positive†) Current RPR titer Previous syphilis serologic test
Woman Neg Oral ulcers + (36) – – 1:64 24 mo Negative Primary
MSM Neg Tender anal ulcers – NA + (30) 1:16 3 wks 1:1 Primary
MSM HIV Torso and hand rash + (31) NA + (30) 1:64 5 mo Nonreactive Secondary
MSM PrEP Torso rash, penis and perianal rash + (34) NA + (30) 1:128 2 mo Nonreactive Secondary
MSM‡ Neg Maculopapular rash on torso and soles – NA + (26) 1:256 12 mo Unknown Secondary
MSM‡ Neg Ulcer on tongue, scrotal rash + (32) NA + (36) Tongue, + (30); scrotum, + (39) 1:32 26 mo Unknown Primary
MSM HIV Penile ulcer + (34) NA + (40) Penis, + (34) 1:128 4 mo Negative Primary
Bisexual man Neg Penile ulcers – NA – Penis, + (38) 1:32 15 mo Negative Primary
MSM HIV Penile ulcers, torso rash – NA – Penis, + (36) 1:64 12 mo Negative Secondary
MSM HIV Palms and feet rash, ulcers on penis, and nodules on scrotum – NA – Penis, + (36) scrotum, –; palms, –; soles, – 1:128 16 mo 1:1 Secondary

*MSM, men who have sex with men; NA, not applicable; ND, not done; neg, HIV negative and not taking PrEP; PrEP, preexposure prophylaxis for HIV; RPR, rapid plasma reagin; woman, heterosexual woman; –, negative by T. pallidum PCR; +, positive by T. pallidum PCR. †Cycle threshold value of T. pallidum PCR. ‡These 2 patients had syphilis treated at other clinics previously, but the exact RPR at that time is unknown.

Main Article

1These senior authors contributed equally to this article.

Page created: August 31, 2023
Page updated: September 20, 2023
Page reviewed: September 20, 2023
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