Laboratory-Confirmed Case of Yaws in a 10-Year-Old Boy from the Republic of the Congo

Abstract

We report a case of yaws in a patient with puritic cutaneous eruption who was initially suspected of infection with monkeypox. The diagnosis was established by real-time PCR and sequencing of specific treponemal DNA sequences. This is the first report describing the use of DNA sequencing to identify Treponema pallidum subsp. pertenue-specific sequences in a patient with active yaws.

Molecular Differentiation of Treponema pallidum Subspecies in Skin Ulceration Clinically Suspected as Yaws in Vanuatu Using Real-Time Multiplex PCR and Serological Methods

“…The DNA sequence analysis within IGR19 ruled out the possibility of a TP-pallidum subspecies in the clinical specimens, whereas unique genetic signature sequences of tprI ruled out TP-endemicum as previously described. 6 …”

“…The analytic sensitivity of the real-time quadriplex PCR assay was determined using 10-fold serial dilutions of purified TPpertenue genomic DNA (CDC-1 strain). The analytical specificity of the PCR assay was verified using DNA purified from 10 laboratory strains of TP-pallidum 8,9 (Nichols, SS 14, Mexico A, JV1, DAL-1, Madras, 1 strain from Maryland, 3 strains from Minnesota) and 11 clinical strains from South Africa, 11 13 laboratory strains of TP-pertenue 8,9 (CDC-1, CDC-2, CDC-2575, Samoa D, Samoa F, Ghana 051, Gauthier, and 6 strains from Indonesia), a clinical strain from Democratic Republic of the Congo, 6 and 2 strains of TP-endemicum (Bosnia A and Iraq B). In addition, a previously used panel of nonpathogenic treponemes (T. denticola, T. refringens, and T. phagedenis) and other microorganisms was included to determine the specificity of the assay.…”

“…was done as previously described using PCR and sequencing of a 280-bp intergenic spacer (IGR19) between the fliG gene (tp0026) and a putative hemolysin gene (tp0027) and a 493-bp specific region within the tprI (tp0620) gene, which is present in all three subspecies. 6 The DNA sequencing was performed using the BigDye Terminator v3.1 cycle sequencing kit and an ABI 3130-XL sequencer. Lasergene Software (DNASTAR, Inc., Madison, MI) was used to assemble and align DNA sequences.…”

“…However, subspecies-specific genetic signatures permit molecular differentiation using methods that involve polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP), and DNA sequencing. 3,[6][7][8][9] These existing molecular methods are inherently technically complex resulting in inevitable delays in reporting results. We therefore developed a TaqMan-based real-time quadriplex PCR assay to rapidly and simultaneously differentiate between TP-pallidum, TPpertenue, and TP-endemicum in a single test that can be used for screening and investigation of individual cases.…”

2014 European guideline on the management of syphilis

“…endemicum, pinty -T. carateum). Te patogeny są morfologicznie i antygenowo podobne i mogą być zróżnicowane tylko na podstawie różnic w sposobie transmisji, epidemiologii, objawów klinicznych zakażenia, a niektóre z nich, od niedawna, poprzez sekwencjonowanie DNA [38]. Osoba mająca dodatnie wyniki odczynów serologicznych powinna być zbadana i leczona jak osoba z kiłą, chyba że udokumentowana jest historia leczenia jej w przeszłości.…”