Canadian Public Health Laboratory Network National Syphilis Laboratory Testing Recommendations: Introduction

Tsang, Raymond S. W.; Morshed, Muhammad; Allen, Vanessa; Chernesky, Max; Fonseca, Kevin; Garceau, Richard; Jayaraman, Gayatri; Kadkhoda, Kamran; Lee, Bonita E.; Levett, Paul N.; Radons, Sandra M; Serhir, Bouchra; Singh, Ameeta E.; Wong, Tom

doi:10.1155/2015/808405

Cited by 3 publications

(2 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although immunohistochemistry is not currently recommended for syphilis diagnosis in non-sterile sites [4], [5], positive results with PCR and serology, in conjunction with routine histopathology, are highly suggestive of the diagnosis. This case highlights the need to become more familiar with the numerous faces of syphilis, “the great imitator”, and to consider syphilis in the differential diagnosis of sub-acute and chronic oral ulcers.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A non-healing syphilid: Another face of the great imitator

Anid¹,

Isaac

Penner

et al. 2017

IDCases

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

“…Globally, the re-emergence of syphilis has been well-documented in the past decade, especially in industrialized countries with numerous emerging outbreaks reported [3], [4], [5]. This requires that clinicians be cognizant of various clinical manifestations of syphilis.…”

Section: Discussionmentioning

confidence: 99%

A non-healing syphilid: Another face of the great imitator

Anid¹,

Isaac

Penner

et al. 2017

IDCases

Self Cite

View full text Add to dashboard Cite

show abstract

Tonsillar Syphilis: an Unusual Site of Infection Detected by Treponema pallidum PCR

Smith¹,

Tsang

Kadkhoda

2015

J Clin Microbiol

Self Cite

View full text Add to dashboard Cite

e With the reemergence of syphilis, it is important that both clinical and public health practitioners recognize the various clinical manifestations of this disease (formerly known as "the great imitator") and become familiar with the newer diagnostic tests. Here we report the first case of tonsillar syphilis diagnosed by PCR. CASE REPORT In October 2014, a 58-year-old homosexual male in a long-term exclusive relationship with a man presented to the Gay Men's Health Clinic at Our Own Health Centre in Winnipeg, Manitoba, Canada, with a 2-week history of sore throat and left otalgia. He confirmed that he still had only one partner. On examination, his left tonsil was unusually smooth, red, and quite enlarged. His left tonsillar lymph node was tender and was significantly enlarged to 2.5 to 3 cm in diameter. The result of otoscopy of the left ear was normal, and he was given a presumptive diagnosis of viral tonsillitis. A throat swab for beta-hemolytic streptococci was negative by culture. He declined sexually transmitted infection (STI) screening at his first visit.He returned a week later feeling anxious because he remembered that he had had an extrarelationship contact involving oral sex with another man at a party about 8 weeks earlier (that was approximately 5 weeks prior to the onset of otalgia). He stated he had never received anal sex. On examination, there was now a thin film of white slough on the surface of his left tonsil with no other lesions or patches found in his mouth. He was treated with penicillin V (600 mg every 12 h [q12h]) for 12 days, pending return of laboratory investigations ordered on the basis of the revised history provided and consent for STI screening. A throat swab for culture and a urine specimen for a nucleic acid amplification test (NAAT) were both negative for Neisseria gonorrhoeae. A direct fluorescent antibody assay (DFA) of a throat swab and a NAAT of urine specimens were both negative for Chlamydia trachomatis. A second throat swab taken for routine culture was again negative for beta-hemolytic streptococci. A serum sample was sent for syphilis, hepatitis B virus (HBV), and human immunodeficiency virus (HIV) serology at the Cadham Provincial Public Health Laboratory in Winnipeg, Manitoba, Canada. The patient had previously tested negative for syphilis serology by the use of a treponema-specific antibody a year prior to the current visit. Because of his clinical presentation and the history that he provided, as well as the ongoing syphilis outbreak happening among men who have sex with men (MSM) in Winnipeg, a throat swab (Dacron in viral transport medium at 4°C) was also sent to the National Microbiology Laboratory (NML) in Winnipeg, Canada, for syphilis PCR testing. When the tonsil was swabbed for testing, a shallow erosion was revealed with superficial bleeding. He subsequently tested negative for both HBV (by a surface antigen test) and HIV (by an HIV-1/2 antibody plus HIV p24 antigen combo assay). Syphilis serology results were as follows: Treponema pallidum antibody posi...

show abstract

An update on the status of direct testing for Treponema pallidum subspecies pallidum for the laboratory diagnosis of syphilis in Canada

Alexander,

Morshed,

Stein

et al. 2024

Journal of the Association of Medical Microbiology and Infectio

View full text Add to dashboard Cite

Background: In Canada, the recent resurgence of infectious syphilis and rising rates of congenital syphilis have renewed interest in direct detection methods for the laboratory diagnosis of syphilis. The Canadian Public Health Laboratory Network (CPHLN) has previously published a series of guidelines for the diagnosis of syphilis in Canada, including the use of direct tests. In the decade since those guidelines were published, laboratory practice has changed. Methods: This systematized review combined a literature search (MEDLINE) of methods for direct detection of Treponema pallidum with an informal survey of current testing practices in Canadian public health laboratories. Results: Direct testing methods have favourable performance characteristics for detection of early syphilis and congenital cases. Although no government licensed commercial nucleic acid amplification test (NAAT) for syphilis is available in Canada, laboratory-developed tests have been implemented in multiple Canadian jurisdictions. Clinical specimens with the highest yield of positive NAAT results for syphilis include genital ulcers, skin lesions, and oral swabs from primary and secondary syphilis patients. For investigation of congenital syphilis, nasopharyngeal, placenta, umbilical cord, blood, and skin lesions are specimens of choice for direct detection of T. pallidum by NAAT. Conclusions: This update on the status of direct testing highlights the importance of NAAT for the detection of T. pallidum, the reduced role of microscopy-based methods, and the emergence of DNA and genome sequencing as tools for phylogenetic analysis and molecular epidemiology.

show abstract

Canadian Public Health Laboratory Network National Syphilis Laboratory Testing Recommendations: Introduction

Cited by 3 publications

References 12 publications

A non-healing syphilid: Another face of the great imitator

A non-healing syphilid: Another face of the great imitator

Tonsillar Syphilis: an Unusual Site of Infection Detected by Treponema pallidum PCR

An update on the status of direct testing for Treponema pallidum subspecies pallidum for the laboratory diagnosis of syphilis in Canada

Contact Info

Product

Resources

About