Table 3. Characteristics of 10 syphilis patients with signs and symptoms of syphilis who had a positive serologic test and Treponema pallidum PCR detection from mucosal sites or lesion sites in retrospective study of patients who visited the Melbourne Sexual Health Centre, Melbourne, Victoria, Australia, during November 2018–March 2020*.
| Group by sexual practice | HIV/PrEP status | Signs on examination | Mucosal PCR sites (value if positive†) |
Serologic test results |
Previous serologic test results (RPR titer if reactive) | Staging of syphilis | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Oral cavity | Vagina | Anus | Lesion PCR sites (value if positive†) | Current RPR titer | Previous syphilis serologic test | ||||||
| Woman | Neg | Oral ulcers | + (36) | – | – | 1:64 | 24 mo | Negative | Primary | ||
| MSM | Neg | Tender anal ulcers | – | NA | + (30) | 1:16 | 3 wks | 1:1 | Primary | ||
| MSM | HIV | Torso and hand rash | + (31) | NA | + (30) | 1:64 | 5 mo | Nonreactive | Secondary | ||
| MSM | PrEP | Torso rash, penis and perianal rash | + (34) | NA | + (30) | 1:128 | 2 mo | Nonreactive | Secondary | ||
| MSM‡ | Neg | Maculopapular rash on torso and soles | – | NA | + (26) | 1:256 | 12 mo | Unknown | Secondary | ||
| MSM‡ | Neg | Ulcer on tongue, scrotal rash | + (32) | NA | + (36) | Tongue, + (30); scrotum, + (39) | 1:32 | 26 mo | Unknown | Primary | |
| MSM | HIV | Penile ulcer | + (34) | NA | + (40) | Penis, + (34) | 1:128 | 4 mo | Negative | Primary | |
| Bisexual man | Neg | Penile ulcers | – | NA | – | Penis, + (38) | 1:32 | 15 mo | Negative | Primary | |
| MSM | HIV | Penile ulcers, torso rash | – | NA | – | Penis, + (36) | 1:64 | 12 mo | Negative | Secondary | |
| MSM | HIV | Palms and feet rash, ulcers on penis, and nodules on scrotum | – | NA | – | Penis, + (36) scrotum, –; palms, –; soles, – | 1:128 | 16 mo | 1:1 | Secondary | |
*MSM, men who have sex with men; NA, not applicable; ND, not done; neg, HIV negative and not taking PrEP; PrEP, preexposure prophylaxis for HIV; RPR, rapid plasma reagin; woman, heterosexual woman; –, negative by T. pallidum PCR; +, positive by T. pallidum PCR. †Cycle threshold value of T. pallidum PCR. ‡These 2 patients had syphilis treated at other clinics previously, but the exact RPR at that time is unknown.