Changing patterns of treponemal disease

Primary and secondary syphilis, 20 years' experience. 2. Clinical features

The notes of 946 patients with primary and 854 with secondary syphilis were retrospectively reviewed. Of the 184 heterosexual men with primary syphilis, 182 (99%) had chancres affecting the penis, compared with 467 (64%) of the 728 homosexual men (p less than 0.0001). Anorectal chancres occurred in 249 (34%) of homosexual men. The commonest features of secondary syphilis included a rash, lymphadenopathy, and mucous patches of the mouth or genital area. Hepatitis, meningitis, other neurological problems, iridocyclitis, and periostitis were all exceptionally rare. The clinical features of primary and secondary syphilis do not appear to have changed in recent years.

Genetics of Treponema: relationship between Treponema pallidum and five cultivable treponemes

Three genetically distinct groups of treponemes have been identified by saturation reassociation assays using 125I-labeled treponemal DNAs. The three groups are (i) virulent Treponema pallidum (Nichols strain), (ii) T. phagedenis and its biotypes Reiter and Kazan 5, and (iii) T. refringens biotypes Nichols and Noguchi. There is no detectable DNA sequence homology (less than 5%) among the three groups. The groups have distinct guanine + cytosine contents: 52.4 to 53.7% for T. pallidum, 41.5% for T. refringens, and 38 to 39% for T. phagedenis.