Perineal syphilitic gumma: tertiary syphilis in a developed country

Varejão, Ana Mesquita; Monteiro, Diana; Peixinho, Catarina

doi:10.1136/bcr-2022-250564

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…2,14 Gummas are typically 2 -10 cm large. 15 The gummatous skin lesions may appear anywhere on the body and have been described on the face, oral cavity, and penis, as well as the hands, as in our patient. 2,10,13,14,16 In particular, it is prudent to add tertiary syphilis to the short differential of skin rashes found on the palm and soles.…”

Section: Discussionsupporting

confidence: 66%

The Continued Rise of Syphilis: A Case Report to Aid in Identification of the Great Imitator

Finney,

Soyfer,,

Schwan

et al. 2023

JETEM

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Section: Discussionsupporting

confidence: 66%

The Continued Rise of Syphilis: A Case Report to Aid in Identification of the Great Imitator

Finney,

Soyfer,,

Schwan

et al. 2023

JETEM

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“…Currently, only multiple high doses of benzathine penicillin G is used for treating late-stage syphilis infections; in neurosyphilis penicillin G or procaine penicillin is used 22 . The biological basis of tertiary syphilis is not well understood but numerous accounts of the use of benzathine penicillin G to ameliorate or recover from debilitating symptoms provide a strong argument for the use of antibiotics in these instances 60 – 66 . The high degree of efficacy at low nanomolar concentrations of the compounds, with several compounds having lower MICs compared to benzathine penicillin G, make them strong candidates for future in vivo studies (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

A large screen identifies beta-lactam antibiotics which can be repurposed to target the syphilis agent

Hayes

Dressler

Norris

et al. 2023

npj Antimicrob Resist

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Syphilis, caused by the spirochete Treponema pallidum subsp. pallidum (hereafter called T. pallidum), is re-emerging as a worldwide sexually transmitted infection. A single intramuscular dose of benzathine penicillin G is the preferred syphilis treatment option. Both supply shortage concerns and the potential for acquired antibiotic resistance further the need to broaden the repertoire of syphilis therapeutics. We reasoned that other β-lactams may be equally or more effective at targeting the disease-causing agent, Treponema pallidum, but have yet to be discovered due to a previous lack of a continuous in vitro culture system. Recent technical advances with respect to in vitro T. pallidum propagation allowed us to conduct a high-throughput screen of almost 100 β-lactams. Using several molecular and cellular approaches that we developed or adapted, we identified and confirmed the efficacy of several β-lactams that were similar to or outperformed the current standard, benzathine penicillin G. These options are either currently used to treat bacterial infections or are synthetic derivatives of naturally occurring compounds. Our studies not only identified additional potential therapeutics in the resolution of syphilis, but provide techniques to study the complex biology of T. pallidum—a spirochete that has plagued human health for centuries.

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