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. 2016 Aug;43(8):524-7.
doi: 10.1097/OLQ.0000000000000478.

Molecular Typing of Treponema pallidum in Ocular Syphilis

Sara Oliver  1 , Sharon K Sahi, Lauren C Tantalo, Charmie Godornes, Robyn Neblett Fanfair, Lauri E Markowitz, Sheila A Lukehart, Christina M Marra
Affiliations

Molecular Typing of Treponema pallidum in Ocular Syphilis

Sara Oliver et al. Sex Transm Dis. 2016 Aug.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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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Conflict of interest statement

The authors report no conflict of interest

Figures

Figure 1
Figure 1. Complete and Partial T. pallidum Strain Types in Ocular Syphilis — United States, 2015
Figure 2
Figure 2. Complete and Partial T. pallidum Strain Types in Ocular and Non-Ocular Syphilis — Seattle, WA, 2015
See this image and copyright information in PMC

Comment in

  • Ocular Syphilis in Context.
    Hook EW 3rd. Hook EW 3rd. Sex Transm Dis. 2016 Aug;43(8):528-9. doi: 10.1097/OLQ.0000000000000499. Sex Transm Dis. 2016. PMID: 27414685 No abstract available.

References

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