Sexually Transmitted Diseases
Article
Molecular Analysis
Myint, Michael MD*; Bashiri, Houman MS†; Harrington, Robert D. MD*; Marra, Christina M. MD*†
Departments of *Medicine (Infectious Diseases) and †Neurology, University of Washington School of Medicine, Seattle, Washington
The authors thank Arturo Centurion-Lara, MD, John Mittler, PhD, and Sheila A. Lukehart, PhD, for manuscript review and helpful discussion and suggestions.
Supported by grants NIH/NINDS 34235, NIH/NINDS 38663 and NIH/NINDS 39406 (to CMM).
Correspondence: Christina M. Marra, MD, Harborview Medical Center Box 359775, 325 9th Avenue, Seattle, WA 98104-2499. E-mail: [email protected]
Received for publication September 4, 2003,
revised November 5, 2003, and accepted November 6, 2003.
Background and Objectives
It is difficult to distinguish between relapse and reinfection in patients who develop a second episode of syphilis after treatment.
Goal
The goal of this study was to use molecular methods to distinguish between relapse and reinfection in a patient with recurrent secondary syphilis.
Study Design
Treponema pallidum tprK sequences were amplified from cerebrospinal fluid (CSF), skin, and blood from the initial presentation and from blood from the second presentation. Neighbor-joining clustering analysis was performed for deduced tprK sequences from the case patient and for sequences derived from blood and CSF of a different patient with secondary syphilis.
Results
The case patient’s tprK sequences from both episodes of syphilis clustered together with a high degree of similarity.
Conclusion
Our patient likely relapsed despite treatment.