spirochetes

螺旋体
  • 文章类型: Journal Article
    新出现和重新出现的病原体通常源于人畜共患的起源,人与动物之间的循环,并且经常被食血节肢动物载体所引导和维持。这些疾病因子在脊椎动物宿主之间成功传播的效率受到许多因素的影响。包括载体供料的宿主。莱姆病细菌伯氏疏螺旋体已适应在复杂的宿主环境中生存,由Ixodes滴答声矢量化,并保存在多个脊椎动物宿主中。莱姆在不同宿主环境中的多功能性是一个令人信服的平台,可以研究通过脊椎动物和蜱的复杂网络决定病原体传播的机制。鳞茎,现存爬行动物中最多样化的一种,主要由蜥蜴组成,其中许多很容易被Ixodes蜱虫喂食。然而,蜥蜴是研究最少的类群之一,有可能促进莱姆疏螺旋体的传播和生命周期维持。在这次审查中,我们总结目前的证据,从现场监测到实验室感染研究,支持他们对莱姆的贡献。我们还总结了目前对不同蜥蜴免疫反应的理解,这些免疫反应可能解释了在脊椎动物宿主中赋予莱姆螺旋体存活的潜在分子机制。这篇综述提供了关于蜥蜴-tick-疏螺旋体相互作用之间存在的潜在植物性周期的关键观点,并强调了生态免疫学透镜在人畜共患病原体传播研究中的重要性。
    Emerging and re-emerging pathogens often stem from zoonotic origins, cycling between humans and animals, and are frequently vectored and maintained by hematophagous arthropod vectors. The efficiency by which these disease agents are successfully transmitted between vertebrate hosts is influenced by many factors, including the host on which a vector feeds. The Lyme disease bacterium Borrelia burgdorferi sensu lato has adapted to survive in complex host environments, vectored by Ixodes ticks, and maintained in multiple vertebrate hosts. The versatility of Lyme borreliae in disparate host milieus is a compelling platform to investigate mechanisms dictating pathogen transmission through complex networks of vertebrates and ticks. Squamata, one of the most diverse clade of extant reptiles, is comprised primarily of lizards, many of which are readily fed upon by Ixodes ticks. Yet, lizards are one of the least studied taxa at risk of contributing to the transmission and life cycle maintenance of Lyme borreliae. In this review, we summarize the current evidence, spanning from field surveillance to laboratory infection studies, supporting their contributions to Lyme borreliae circulation. We also summarize the current understanding of divergent lizard immune responses that may explain the underlying molecular mechanisms to confer Lyme spirochete survival in vertebrate hosts. This review offers a critical perspective on potential enzootic cycles existing between lizard-tick-Borrelia interactions and highlights the importance of an eco-immunology lens for zoonotic pathogen transmission studies.
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  • 文章类型: Journal Article
    莱姆病(LB)是北半球最常见的媒介传播疾病,由属于伯氏疏螺旋体(Bbsl)复合体的螺旋体引起。螺旋体螺旋体在蜱载体和不同脊椎动物宿主之间以强制性传播周期循环。为了成功完成这个复杂的传输周期,Bbsl编码一系列蛋白质,包括已知的PFam54蛋白家族,或提议,对储层宿主和/或载体适应性的影响。即便如此,关于PFam54基因阵列中自然发生的变异水平,尤其是与欧亚分布物种有关的变异,只有零碎的信息可用。利用来自欧亚大陆三种主要引起LB的疏螺旋体物种的分离株(n=141)的全基因组数据(B.afzelii,B.巴伐利亚,和B.garinii),我们旨在表征这些分离株中PFam54基因阵列的多样性,以促进在种内和种间水平上了解PFam54旁系同源物的进化。我们在PFam54基因阵列中发现了异常高的变异水平,其中39个PFam54旁系同源物属于23个直系同源组,其中包括5个新的旁系同源物。即便如此,在所研究的疏螺旋体物种的进化史上,基因阵列似乎保持相当稳定。有趣的是,进化枝IV之外的基因,其中包含编码与疏螺旋体发病机制相关的蛋白质的基因,更频繁地显示出在假设的载体或宿主物种不同的进化枝之间进行多样化选择的特征。这可能表明,非分支IV旁系同源物在宿主和/或载体适应中的作用比以前预期的更重要。这将需要未来的实验室研究来验证。
    Lyme borreliosis (LB) is the most common vector-borne disease in the Northern Hemisphere caused by spirochetes belonging to the Borrelia burgdorferi sensu lato (Bbsl) complex. Borrelia spirochetes circulate in obligatory transmission cycles between tick vectors and different vertebrate hosts. To successfully complete this complex transmission cycle, Bbsl encodes for an arsenal of proteins including the PFam54 protein family with known, or proposed, influences to reservoir host and/or vector adaptation. Even so, only fragmentary information is available regarding the naturally occurring level of variation in the PFam54 gene array especially in relation to Eurasian-distributed species. Utilizing whole genome data from isolates (n = 141) originated from three major LB-causing Borrelia species across Eurasia (B. afzelii, B. bavariensis, and B. garinii), we aimed to characterize the diversity of the PFam54 gene array in these isolates to facilitate understanding the evolution of PFam54 paralogs on an intra- and interspecies level. We found an extraordinarily high level of variation in the PFam54 gene array with 39 PFam54 paralogs belonging to 23 orthologous groups including five novel paralogs. Even so, the gene array appears to have remained fairly stable over the evolutionary history of the studied Borrelia species. Interestingly, genes outside Clade IV, which contains genes encoding for proteins associated with Borrelia pathogenesis, more frequently displayed signatures of diversifying selection between clades that differ in hypothesized vector or host species. This could suggest that non-Clade IV paralogs play a more important role in host and/or vector adaptation than previously expected, which would require future lab-based studies to validate.
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  • 文章类型: Journal Article
    复发性发热(RF)仍然是一种被忽视的人类疾病,是由许多不同的致病性疏螺旋体(B.)物种。以人体血液中的高细胞密度为特征,复发性发热螺旋体已经开发了丰富的策略来避免宿主防御机制的识别。在这种情况下,已知在与宿主衍生分子的相互作用中表现出多功能结合特性的螺旋体脂蛋白在粘附中起关键作用,纤维蛋白溶解和补体激活。
    通过ELISA检查CihC/FbpC直向同源物与不同人蛋白质的结合以及蛋白质结合的纤溶酶原向蛋白水解活性纤溶酶的转化。分析CihC/FbpC直向同源物对补体激活的抑制能力,进行了基于微量滴定的方法.最后,利用AlphaFold预测来鉴定补体相互作用残基。
    这里,我们阐明了CihC/FbpC直向同源物从不同的RF螺旋体,包括B.parkeri,B.Hermsii,B.Turicatae,和B.对人纤连蛋白的复发,纤溶酶原,和补体成分C1r。所有CihC/FbpC直向同源物显示与纤连蛋白相似的结合特性,纤溶酶原,还有C1r,分别。功能研究揭示了纤溶酶原与所有疏螺旋体蛋白的剂量依赖性结合并转化为活性纤溶酶。氨甲环酸几乎完全消除了纤溶酶的蛋白水解活性,表明赖氨酸残基参与与这种丝氨酸蛋白酶的相互作用。此外,对于野生型CihC/FbpC-直系同源物以及复发性芽孢杆菌的C末端CihC片段,可以证明对经典途径的强失活能力。人血清与除CihC/FbpC变体外的疏螺旋体分子的预孵育缺乏C末端区域,可保护血清易感疏螺旋体细胞免受补体介导的裂解。利用AlphaFold2预测和现有的晶体结构,我们将C1r结合中涉及的推定关键残基定位在CihC/FbpC直向同源物上,试图解释C1r结合亲和力相对较小的差异,尽管有关键残基的取代。总的来说,我们的数据促进了对被认为参与发病机制和毒力的复发性发热螺旋体的结构和功能高度相似分子的多种结合特性的理解.
    UNASSIGNED: Relapsing fever (RF) remains a neglected human disease that is caused by a number of diverse pathogenic Borrelia (B.) species. Characterized by high cell densities in human blood, relapsing fever spirochetes have developed plentiful strategies to avoid recognition by the host defense mechanisms. In this scenario, spirochetal lipoproteins exhibiting multifunctional binding properties in the interaction with host-derived molecules are known to play a key role in adhesion, fibrinolysis and complement activation.
    UNASSIGNED: Binding of CihC/FbpC orthologs to different human proteins and conversion of protein-bound plasminogen to proteolytic active plasmin were examined by ELISA. To analyze the inhibitory capacity of CihC/FbpC orthologs on complement activation, a microtiter-based approach was performed. Finally, AlphaFold predictions were utilized to identified the complement-interacting residues.
    UNASSIGNED: Here, we elucidate the binding properties of CihC/FbpC-orthologs from distinct RF spirochetes including B. parkeri, B. hermsii, B. turicatae, and B. recurrentis to human fibronectin, plasminogen, and complement component C1r. All CihC/FbpC-orthologs displayed similar binding properties to fibronectin, plasminogen, and C1r, respectively. Functional studies revealed a dose dependent binding of plasminogen to all borrelial proteins and conversion to active plasmin. The proteolytic activity of plasmin was almost completely abrogated by tranexamic acid, indicating that lysine residues are involved in the interaction with this serine protease. In addition, a strong inactivation capacity toward the classical pathway could be demonstrated for the wild-type CihC/FbpC-orthologs as well as for the C-terminal CihC fragment of B. recurrentis. Pre-incubation of human serum with borrelial molecules except CihC/FbpC variants lacking the C-terminal region protected serum-susceptible Borrelia cells from complement-mediated lysis. Utilizing AlphaFold2 predictions and existing crystal structures, we mapped the putative key residues involved in C1r binding on the CihC/FbpC orthologs attempting to explain the relatively small differences in C1r binding affinity despite the substitutions of key residues. Collectively, our data advance the understanding of the multiple binding properties of structural and functional highly similar molecules of relapsing fever spirochetes proposed to be involved in pathogenesis and virulence.
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  • 文章类型: Journal Article
    疏螺旋体是一种蜱传螺旋体发热的病原体,牛的冷漠和食物消耗减少。分子诊断扩大了对疏螺旋体的理解,描述了新的宿主和地理位置。本研究旨在描述南美野生tap(Tapirusterrestris)中对B.theileri的首次分子检测。使用基于疏螺旋体属的16SrRNA基因的qPCR分析,筛选了从潘塔纳尔(n=61)和Cerrado(n=38)生物群落中采样的99个tap中获得的血液DNA样品。对qPCR测定中的阳性样品进行PCR测定以允许表征来自16SrRNA和flaB基因的片段。来自潘塔纳尔生物群落的两只(2/99;2.0%)动物在qPCR中呈阳性,并且一个样品呈现flaB方案的预期大小的条带。来自该样品的扩增子被成功地克隆和测序。在系统发育分析中,疏螺旋体sp.来自T.terrestris,与先前在巴西米纳斯吉拉斯州的Rhipicephalusmicrotick和牛中检测到的B.theileri序列一起,来自马里的Rhipicephalusgeigyi,以及来自巴基斯坦的R.microplus和sumaphysalissulcata。这一发现有助于我们了解B.theileri的易感宿主物种。需要更多的研究来了解B.theileri对tapir健康的潜在影响。
    Borrelia theileri is a tick-borne spirochete causative agent of fever, apathy and reduced food consumption in cattle. Molecular diagnosis has expanded the understanding of Borrelia theileri with new hosts and geographical locations being described. The present study aimed to describe the first molecular detection of B. theileri in wild tapirs (Tapirus terrestris) from South America. Blood DNA samples obtained from 99 tapirs sampled in Pantanal (n = 61) and Cerrado (n = 38) biomes were screened using a qPCR assay based on the 16 S rRNA gene of Borrelia sp. Positive samples in the qPCR assay were subjected to PCR assays to allow characterization of fragments from 16 S rRNA and flaB genes. Two (2/99; 2.0%) animals from Pantanal biome were positive in the qPCR and one sample presented bands of expected size for the flaB protocol. Amplicons from this sample were successfully cloned and sequenced. In the phylogenetic analysis, Borrelia sp. from T. terrestris grouped together with B. theileri sequences previously detected in Rhipicephalus microplus ticks and cattle from Minas Gerais State in Brazil, Rhipicephalus geigyi from Mali, and R. microplus and Haemaphysalis sulcata from Pakistan. This finding contributes to our knowledge regarding susceptible hosts species for B. theileri. More studies are necessary to understand the potential effects of B. theileri on tapir\'s health.
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  • 文章类型: Journal Article
    螺旋体是一种通过硬蜱传播的螺旋体。在日本发现之后,这种病原体已经在世界各地被发现,并且越来越多地被证实是引起发热疾病的人类病原体,即复发性发热。它的存在已在中国东北得到证实。然而,在包括云南省在内的中国南部,关于米亚莫托伊和其他硬蜱传复发性螺旋体的信息很少,蜱和动物种类丰富,许多人都居住和参观娱乐。
    对于本研究,我们采集了蜱虫的样本,野生动物,和来自云南省不同县的家畜寄主。从样品中提取核酸,使用16SrRNA特异性靶基因片段的聚合酶链反应(PCR)确认了B.miyamotoi和其他复发性发热螺旋体的存在。然后扩增阳性样品的flaB和glpQ基因的部分基因组。用SPSS20软件对其分布进行统计学差异分析。部分16SrRNA的序列,分析了flaB和glpQ基因组,并构建了系统进化树。
    总共8260个样品,包括2304个蜱,收集4120只小型哺乳动物和1836只家畜宿主的血液,以筛查B.miyamotoi和其他复发性发热螺旋体的感染。牛和羊是主要寄主,而Rhipicephalusmicroplus,奈帕氏血盐,H.kolonini和Ixodesovatus被确定为重要的载体宿主,具有高患病率或广泛分布。只有一只卡罗利小母鼠(小鼠)和一只SorexAlpinus(泼妇)被证实对复发性发热螺旋体呈阳性。蜱垂直传播的证据也得到了证实。两种已知的B.miyamotoi菌株和一种新型复发性发热螺旋体,B.类似泰勒里的特工,被证实并描述为他们的宿主适应,突变,以及人类传播和溢出的潜在风险。
    我们的研究结果为云南省病媒和动物宿主中复发性发热螺旋体的大样本量提供了新的证据,并为进一步调查提供指导,监测和监测这种病原体。
    UNASSIGNED: Borrelia miyamotoi is a spirochete species transmitted via hard ticks. Following its discovery in Japan, this pathogen has been detected around the world, and is increasingly confirmed as a human pathogen causing febrile disease, namely relapsing fever. Its presence has been confirmed in the Northeast China. However, there is little information regarding the presence of B. miyamotoi and other hard-tick-borne relapsing fever spirochetes in southern China including Yunnan province, where tick and animal species are abundant and many people both inhabit and visit for recreation.
    UNASSIGNED: For the present study, we collected samples of ticks, wildlife, and domestic animal hosts from different counties in Yunnan province. Nucleic acids from samples were extracted, and the presence of B. miyamotoi and other relapsing fever spirochetes was confirmed using polymerase chain reaction (PCR) for the 16S rRNA specific target gene fragment. The positive samples were then amplified for partial genome of the flaB and glpQ genes. Statistical differences in its distribution were analyzed by SPSS 20 software. Sequence of partial 16S rRNA, flaB and glpQ genome were analyzed and phylogenetic trees were constructed.
    UNASSIGNED: A total of 8260 samples including 2304 ticks, 4120 small mammals and 1836 blood of domestic animal hosts were collected for screening for infection of B. miyamotoi and other relapsing fever spirochetes. Cattle and sheep act as the main hosts and Rhipicephalus microplus, Haemaphysalis nepalensis, H. kolonini and Ixodes ovatus were identified as the important vector host with high prevalence or wide distribution. Only one Mus caroli (mouse) and one Sorex alpinus (shrew) were confirmed positive for relapsing fever spirochetes. Evidence of vertical transmission in ticks was also confirmed. Two known strains of B. miyamotoi and one novel relapsing fever spirochetes, B. theileri-like agent, were confirmed and described with their host adaptation, mutation, and potential risk of spreading and spillover for human beings.
    UNASSIGNED: Our results provide new evidence of relapsing fever spirochetes in vector and animal hosts in Yunnan province based on large sample sizes, and offer guidance on further investigation, surveillance and monitoring of this pathogen.
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  • 文章类型: Journal Article
    致病性螺旋体引起一系列严重的人类疾病,如莱姆病(LD),梅毒,钩端螺旋体病,复发性发热(RF),和牙周病.运动性是螺旋体的关键毒力因子。从感染的机械角度来看,人们普遍认为鞭毛是控制这些病原体在宿主中迁移和传播的唯一关键角色。这里,我们强调了螺旋体表面暴露的粘附分子及其在感染过程中与宿主分子的动态相互作用的重要贡献,特别是在螺旋体游泳和爬行迁徙中。我们认为,这些最近的发现推翻了将螺旋体体描述为只是一个惰性弹性袋的普遍观点,这不会影响螺旋细胞的运动。
    Pathogenic spirochetes cause a range of serious human diseases such as Lyme disease (LD), syphilis, leptospirosis, relapsing fever (RF), and periodontal disease. Motility is a critical virulence factor for spirochetes. From the mechanical perspective of the infection, it has been widely believed that flagella are the sole key players governing the migration and dissemination of these pathogens in the host. Here, we highlight the important contribution of spirochetal surface-exposed adhesive molecules and their dynamic interactions with host molecules in the process of infection, specifically in spirochetal swimming and crawling migration. We believe that these recent findings overturn the prevailing view depicting the spirochetal body to be just an inert elastic bag, which does not affect spirochetal cell locomotion.
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  • 文章类型: Journal Article
    背景:蜱和虱子传播的复发性发热被高度忽视,由多种疏螺旋体属引起的媒介传播疾病。目前,没有关于肯尼亚蜱和虱子传播的复发性螺旋体热流行的数据。这里,我们提供了肯尼亚北部虱子传播的复发性热(LBRF)血清阳性率的回顾性研究数据。
    方法:一种新的免疫测定法,最近为诊断LBRF而建立的用于筛选2005年从图尔卡纳县没有来源的发烧个体收集的血液样本,2009年至2010年肯尼亚抗LBRF抗体。
    结果:在分析的2005年血清中,287个样品(14.3%)被认为是抗LBRFIgG阳性。随后的分析显示,从这些2005年样品中随机选择的152份血清中的87份对于抗LBRFIgM抗体测试为阳性(57.2%)。大多数IgG和IgM阳性样品来自居住在图尔卡纳县北部地区的个体。
    结论:我们的血清学发现为肯尼亚LBRF的发生提供了强有力的证据。
    BACKGROUND: Tick- and louse-borne relapsing fever are highly-neglected, vector-borne diseases caused by diverse Borrelia species. Presently, there are no data available on the endemicity of tick- and louse-borne relapsing fever spirochetes in Kenya. Here, we present data of a retrospective study on the seroprevalence of louse-borne relapsing fever (LBRF) in northern Kenya.
    METHODS: A novel immunoassay, recently established for the diagnosis of LBRF was utilized to screen 2005 blood samples collected from individuals with fever without a source in Turkana County, Kenya between May 2009 and November 2010 for anti-LBRF antibodies.
    RESULTS: Out of the 2005 sera analyzed, 287 samples (14.3 %) were considered anti-LBRF IgG positive. Subsequent analyses revealed that 87 out of 152 sera randomly selected from these 2005 samples were tested positive (57.2 %) for anti-LBRF IgM antibodies. Most of the IgG and IgM positive samples were from individuals living in northern regions of Turkana County.
    CONCLUSIONS: Our serological finding provides strong evidence for the occurrence of LBRF in Kenya.
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  • 文章类型: Journal Article
    目的:使用大麻,含有多种抗菌药物,可能是牙周炎的危险因素。我们假设多种口服螺旋体对植物大麻素具有抗性,并且大麻二酚(CBD)将充当环境应激源,而Denticola密螺旋体将在转录上做出反应,从而提供对螺旋体生存策略的初步见解。
    方法:在存在和不存在生理相关的植物大麻素剂量的情况下,用分光光度法监测口腔螺旋体的生长。通过RNAseq确定的对植物大麻素暴露的转录反应,在已鉴定的完全测序的口腔螺旋体中,使用qRT-PCR和直系同源物验证了特定的基因活性通量。
    结果:多种口腔螺旋体菌株对CBD(0.1-10μg/mL)具有抗性,而T.denticolaATCC35405对所有测试的植物大麻素具有抗性(CBD,大麻酚[CBN],四氢大麻酚[THC])。RNAseq发现总共392个DenticolaATCC35405基因具有CBD响应性。通过qRT-PCR独立验证这些基因的所选子集。发现通过两种方法差异激活的基因包括几个参与转录调节和毒素控制的基因。抑制的基因包括几种参与趋化性和蛋白水解的基因。
    结论:口腔螺旋体,与其他牙周细菌不同,对生理剂量的植物大麻素具有抗性。对CBD诱导的转录组变化的研究提供了对这种重要牙周病原体抗性机制的了解。应在报告的大麻使用者对牙周炎的易感性增加的背景下考虑这些发现。
    The use of cannabis, which contains multiple antimicrobials, may be a risk factor for periodontitis. We hypothesized that multiple oral spirochetes would be phytocannabinoid-resistant and that cannabidiol (CBD) would act as an environmental stressor to which Treponema denticola would respond transcriptionally, thereby providing first insights into spirochetal survival strategies.
    Oral spirochete growth was monitored spectrophotometrically in the presence and absence of physiologically relevant phytocannabinoid doses, the transcriptional response to phytocannabinoid exposure determined by RNAseq, specific gene activity fluxes verified using qRT-PCR and orthologues among fully sequenced oral spirochetes identified.
    Multiple strains of oral treponemes were resistant to CBD (0.1-10 μg/mL), while T. denticola ATCC 35405 was resistant to all phytocannabinoids tested (CBD, cannabinol [CBN], tetrahydrocannabinol [THC]). A total of 392 T. denticola ATCC 35405 genes were found to be CBD-responsive by RNAseq. A selected subset of these genes was independently verified by qRT-PCR. Genes found to be differentially activated by both methods included several involved in transcriptional regulation and toxin control. Suppressed genes included several involved in chemotaxis and proteolysis.
    Oral spirochetes, unlike some other periodontal bacteria, are resistant to physiological doses of phytocannabinoids. Investigation of CBD-induced transcriptomic changes provided insight into the resistance mechanisms of this important periodontal pathogen. These findings should be considered in the context of the reported enhanced susceptibility to periodontitis in cannabis users.
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  • 文章类型: Journal Article
    目的:梅毒是由螺旋体属的两种不同但遗传上密切相关的细菌(基于整个基因组的序列同一性>98%)引起的人类和lagomorphs的古老疾病。虽然人类梅毒研究得很好,人们对这种病在lagomorph宿主中知之甚少。然而,需要进行比较研究以了解螺旋体病中宿主-病原体共同进化的机制。重要的是,副猪螺旋体感染的野兔群体提供了充分的机会,可以在没有抗生素治疗的自然感染模型人群中研究引起梅毒的病原体。无法从人类梅毒感染中获得的数据。我们提供了有关遗传多样性的数据,并能够突出显示tp0548基因座的两个高变区之一中的各种类型的重复,这些重复在引起人类梅毒的姐妹细菌梅毒螺旋体亚种中尚未描述。苍白球.
    OBJECTIVE: Syphilis is an ancient disease of humans and lagomorphs caused by two distinct but genetically closely related bacteria (>98% sequence identity based on the whole genome) of the genus Treponema. While human syphilis is well studied, little is known about the disease in the lagomorph host. Yet, comparative studies are needed to understand mechanisms in host-pathogen coevolution in treponematoses. Importantly, Treponema paraluisleporidarum-infected hare populations provide ample opportunity to study the syphilis-causing pathogen in a naturally infected model population without antibiotic treatment, data that cannot be obtained from syphilis infection in humans. We provide data on genetic diversity and are able to highlight various types of repetitions in one of the two hypervariable regions at the tp0548 locus that have not been described in the human syphilis-causing sister bacterium Treponema pallidum subsp. pallidum.
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  • 文章类型: Case Reports
    梅毒是一种由梅毒螺旋体引起的细菌性疾病,通过阴道性传播,肛门生殖器,或生殖接触。母亲和未出生的孩子之间的垂直传播也是可能的,但是通过皮肤对皮肤或血液接触传播很少。这种情况的目的是强调梅毒的这种罕见眼部表现,因为它表现为影响许多器官系统的多系统疾病。这是一例46岁的男性视力丧失,由眼科医生转诊至急诊科。在急诊室的演讲前两天,眼科医生观察到左眼存在视盘水肿。在急诊室,他抱怨左眼有明亮的光点,眼睛中央面完全黑暗。他报告说,在急诊就诊前一周,前腹部出现了非瘙痒性红斑皮疹。患者还报告有多个性伴侣。体检结果显示左眼视野缺损,正常的双侧眼球运动,和前腹壁上的皮肤网状物。实验室结果显示全血细胞计数(CBC)和综合代谢组(CMP)在正常范围内,荧光螺旋体抗体(FTA)抗体反应性,人类免疫缺陷病毒(HIV)测试和肝炎面板阴性,快速血浆反应素(RPR)滴度为1:64,影像学结果对任何明显异常均为阴性。咨询了传染病专家,并建议每4小时静脉注射400万单位的青霉素。患者报告在三天内视力模糊有所改善。六个月前,他的视力回到了基线。由于很少发生眼部并发症作为梅毒的初始表现,因此该病例报告具有重要意义。考虑到美国梅毒病例的增加,重要的是要强调这种罕见的梅毒临床表现的可能性。
    Syphilis is a bacterial disease caused by Treponema pallidum and is sexually transmitted via vaginal, anogenital, or orogenital contact. Vertical transmission between mother and unborn child is also possible, but transmission via skin-to-skin or blood contact is rare. The objective of this case is to highlight this rare ocular manifestation of syphilis as it manifests as a multisystemic disease affecting many organ systems. This is a case of a 46-year-old male with vision loss who was referred to the emergency department by an ophthalmologist. Two days before the presentation at the emergency department, the ophthalmologist observed the presence of optic disc edema in the left eye. At the emergency department, he complained of bright light spots in the left eye and complete darkness in the central aspect of the eyes. He reported having a non-pruritic erythematous rash on the anterior abdomen that began one week before his presentation at the emergency department. The patient also reported having multiple sexual partners. Physical examination findings showed a visual field defect in the left eye, normal bilateral eye movement, and a non-tender skin reticulation over the anterior abdominal wall. Lab results showed complete blood count (CBC) and comprehensive metabolic panel (CMP) within normal limits, fluorescent treponemal antibody (FTA) antibody reactive, human immunodeficiency virus (HIV) test and hepatitis panel negative, rapid plasma reagin (RPR) titer 1:64, and imaging results negative for any significant abnormalities. The infectious disease specialists were consulted, and the recommended IV penicillin of four million units every four hours was given. The patient reported an improvement in his blurry vision over three days. By six months, his vision was back to baseline. This case report is significant due to the rare occurrence of ocular complications as an initial presentation of syphilis. Considering the rising cases of syphilis in the United States, it is important to highlight the possibility of this uncommon clinical presentation of syphilis.
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