Cross-reactivity of Anti-Treponema Immunohistochemistry With Non-Treponema Spirochetes: A Simple Call for Caution

Ruiz, Sory J.; Procop, Gary W.

doi:10.5858/arpa.2016-0004-le

Cited by 12 publications

(5 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…From our study, T. pallidum IHC is positive in 100% of IS, a finding also noted by recent observers [20]. Furthermore, T. pallidum IHC is easier to perform and faster to interpret than the commonly used WS stain.…”

Section: Discussionsupporting

confidence: 88%

Treponema pallidum Immunohistochemistry is positive in human intestinal Spirochetosis

et al. 2018

View full text Add to dashboard Cite

Background: Human intestinal spirochetosis (IS) has been recognized for decades, but whether it represents commensalism or a pathogenic process remains controversial. IS is diagnosed on routine stains with confirmation by silver stains but these stains are labor intensive and slow to read. We evaluated the Treponema pallidum immunostain as a diagnostic adjunct for IS. Methods: We retrieved biopsies from 33 patients with IS for this study. Each case was tested by Warthin-Starry (WS) and T. pallidum immunohistochemistry (IHC). Species specific genotyping was performed in 3 cases. Results: Patients with IS ranged from 22 to 82 years without gender predilection. IS involved normal (n = 15), and inflamed (n = 5) mucosa and colonic polyps (n = 13). Warthin-Starry and T. pallidum IHC were positive in all cases including both species of Brachyspira. Six (18%) symptomatic patients were treated for IS, and experienced resolution. In patients diagnosed with incidental IS on cancer screening (n = 5), follow up biopsies, without therapy, were negative for IS. T. pallidum IHC required 75 min less hands-on time than WS for performance and was faster to interpret. Conclusions: T. pallidum IHC can be used to confirm the diagnosis of IS and is easier to perform and faster to interpret than WS.

show abstract

Section: Discussionsupporting

confidence: 88%

Treponema pallidum Immunohistochemistry is positive in human intestinal Spirochetosis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…As the stage of syphilis increases, the sensitivity typically decreases [6] likely due to reduced numbers of organisms. Cross-reactivity with non-Treponema spirochetes has been described with the syphilis IHC and these organisms form part of the normal microbiota of the oropharynx and gastrointestinal tract [14].…”

Section: Discussionmentioning

confidence: 99%

A ruptured thoracic aortic aneurysm and the difficulties of confirming syphilis

Hulme

Werno

Spark

2023

Forensic Sci Med Pathol

View full text Add to dashboard Cite

A 43-year-old woman died suddenly and was found at PM to have a ruptured thoracic aortic aneurysm. The endothelial surface of the aorta showed a 'tree-bark' appearance. Histology of the aneurysm wall showed a patchy, mainly perivascular, plasma cell infiltrate. Multiple spirochete-like organisms were identified on T. pallidum IHC. However, PM syphilis serology (screen including rapid plasma reagin (RPR) and T. pallidum particle agglutination (TPPA)) on femoral blood was negative. PCR testing on FFPE aortic wall tissue was negative. Further history revealed routine antenatal syphilis screening tests had been negative, no known history or risk of exposure to syphilis or other treponemes. This case raises the possibility of false negative syphilis testing. While acknowledged in RPR testing, with the modern testing regime using multiple methods, the rate of false negative results is now thought to be markedly reduced, and false positive results are a much greater problem in clinical medicine. The most common cause of false negative results is early in primary infection before an immune response has been mounted and in those patients that are immunocompromised. False negative results are also more often seen in tertiary syphilis, as in this case. Newer testing methods which include 16S rRNA sequencing have become available and early discussion with a microbiologist would be recommended. Strong macroscopic and microscopic suggestion of syphilis as the cause of the aneurysm makes it necessary to include the possibility of infection in the Post Mortem Report to Coroner as this will have implications for her sexual partners and children.

show abstract

“…Ceci a été confirmé par Tanahashi et al en 2008, à l'aide d'un anticorps anti-tréponème, et également anti-Mycobacterium bovis [4]. D'autres travaux ont corroboré ces données dans les années suivantes, et confirmé l'intérêt de l'anticorps anti-tréponème pour le diagnostic de spirochétose colique [6][7][8]. Notre étude confirme également l'intérêt de l'immunohistochimie pour le diagnostic de spirochétose colique, avec un marquage net, à type de liseré, facile à visualiser en surface des entérocytes.…”

Section: Discussionunclassified

“…En 1996 De Brito et al montraient qu'il était possible de révéler la présence des spirochètes coliques à l'aide d'un anticorps anti-tréponème, en raison d'une réaction croisée entre les deux types de bactéries [5]. Ceci était confirmé par d'autres équipes [4,[6][7][8]. Le but principal de ce travail était d'évaluer dans une série prospective de patients consultant pour une diarrhée chronique avec une endoscopie normale, la fréquence de la spirochétose colique, diagnostiquée par une technique immunohistochimique avec l'anticorps anti-tréponème sur leurs biopsies coliques.…”

Section: Introductionunclassified

Diagnostic immunohistochimique de la spirochétose colique avec l’anticorps anti-tréponème chez les patients consultant pour une diarrhée chronique. Résultats d’une étude prospective menée chez 137 patients

Tesson

Fontaine

Fumery

et al. 2019

Annales de Pathologie

View full text Add to dashboard Cite

Cross-reactivity of Anti-Treponema Immunohistochemistry With Non-Treponema Spirochetes: A Simple Call for Caution

Cited by 12 publications

References 4 publications

Treponema pallidum Immunohistochemistry is positive in human intestinal Spirochetosis

Treponema pallidum Immunohistochemistry is positive in human intestinal Spirochetosis

A ruptured thoracic aortic aneurysm and the difficulties of confirming syphilis

Diagnostic immunohistochimique de la spirochétose colique avec l’anticorps anti-tréponème chez les patients consultant pour une diarrhée chronique. Résultats d’une étude prospective menée chez 137 patients

Contact Info

Product

Resources

About