WordNet

the inner pale yellow part of the lenticular nucleus (同)globus_pallidus, paleostriatum
spirochete that causes disease in humans (e.g. syphilis and yaws)

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(顔・肌などが)青白い,生色のない(pale)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/12/21 21:26:05」(JST)

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Treponema pallidum is a Gram-negative spirochaete bacterium with subspecies that cause treponemal diseases such as syphilis, bejel, pinta and yaws. The treponemes have a cytoplasmic and outer membrane. Using light microscopy treponemes are only visible using Dark field illumination.

Subspecies

There are at least four known subspecies:

Treponema pallidum pallidum, which causes syphilis
T. pallidum endemicum, which causes bejel or endemic syphilis
T. pallidum carateum, which causes pinta
T. pallidum pertenue, which causes yaws

There is some variation as to which are considered subspecies, and which are species. The cause of pinta is sometimes described as Treponema carateum, rather than a subspecies of Treponema pallidum, even when the subspecies convention is used for the other agents.^[1]

Laboratory identification

Micrograph showing Treponema pallidum (black and thin) - Dieterle stain

This bacterium can be detected with special stains, such as the Dieterle stain.

Treponema pallidum is also detected by serology, including nontreponemal VDRL, rapid plasma reagin (RPR) and treponemal antibody tests (FTA-ABS), Treponema pallidum immobilization reaction (TPI) and syphilis TPHA test).^[2]

Clinical significance

T. pallidum pallidum is a motile spirochaete that is generally acquired by close sexual contact, entering the host via breaches in squamous or columnar epithelium. The organism can also be transmitted to a fetus by transplacental passage during the later stages of pregnancy, giving rise to congenital syphilis. The helical structure of T. pallidum pallidum allows it to move in a corkscrew motion through a viscous medium such as mucus. It gains access to host's blood and lymph systems through tissue and mucous membranes.

The subspecies causing yaws, pinta, and bejel are morphologically and serologically indistinguishable from T. pallidum pallidum (syphilis); however, their transmission is not venereal in nature and the course of each disease is significantly different.

Genome

In the 17 July 1998 issue of the journal Science, a group of biologists reported how they sequenced the genome of T. pallidum.^[3] The recent sequencing of the genomes of several spirochetes permits a thorough analysis of the similarities and differences within this bacterial phylum. Treponema pallidum subsp. pallidum has one of the smallest bacterial genomes at 1.14 million base pairs (Mb), and has limited metabolic capabilities, reflecting its adaptation through genome reduction to the rich environment of mammalian tissue. The shape of Treponema pallidum is flat and wavy, unlike the other spirochetes, which are helical.^[4]

Vaccine

There is no vaccine for syphilis. The outer membrane of T. pallidum has too few surface proteins for an antibody to be effective. Efforts to develop a safe and effective syphilis vaccine have been hindered by uncertainty about the relative importance of humoral and cellular mechanisms to protective immunity^{[citation needed]} and the fact that T. pallidum outer membrane proteins have not been unambiguously identified.^[5]

References

^ Antal GM, Lukehart SA, Meheus AZ (January 2002). "The endemic treponematoses". Microbes Infect. 4 (1): 83–94. doi:10.1016/S1286-4579(01)01513-1. PMID 11825779. http://linkinghub.elsevier.com/retrieve/pii/S1286457901015131.
^ Fisher, Bruce; Harvey, Richard P.; Champe, Pamela C.. Lippincott's Illustrated Reviews: Microbiology (Lippincott's Illustrated Reviews Series). Hagerstown, MD: Lippincott Williams & Wilkins. ISBN 0-7817-8215-5.
^ Fraser CM, Norris SJ, Weinstock GM, et al. (July 1998). "Complete genome sequence of Treponema pallidum, the syphilis spirochete". Science 281 (5375): 375–88. doi:10.1126/science.281.5375.375. PMID 9665876. http://www.sciencemag.org/cgi/pmidlookup?view=long&pmid=9665876.
^ Clark, D.P., Dunlap, P.V, Madigan, J.T., Martinko, J.M. Brock Biology of Microorganism. San Francisco: Pearson. 2009. 79 p.
^ Tomson FL, Conley PG, Norgard MV, Hagman KE (September 2007). "Assessment of cell-surface exposure and vaccinogenic potentials of Treponema pallidum candidate outer membrane proteins". Microbes Infect. 9 (11): 1267–75. doi:10.1016/j.micinf.2007.05.018. PMC 2112743. PMID 17890130. http://linkinghub.elsevier.com/retrieve/pii/S1286-4579(07)00200-6.

External links

"Syphilis- CDC Fact Sheet." Centers for Disease Control and Prevention. May. 2004. Centers for Disease Control and Prevention. 7 February 2006

UpToDate Contents

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1. 早期梅毒の病因、臨床症状、および治療 pathogenesis clinical manifestations and treatment of early syphilis
2. 梅毒の診断的検査 diagnostic testing for syphilis
3. 後期梅毒の病因、臨床症状、および治療 pathogenesis clinical manifestations and treatment of late syphilis
4. 梅毒の病態生理、伝播、および自然史 pathophysiology transmission and natural history of syphilis
5. 妊娠中の梅毒 syphilis in pregnancy

English Journal

High prevalence of syphilis among demobilized child soldiers in Eastern Congo: A cross-sectional study.

Senga RK, Lutala PM.AbstractABSTRACT: BACKGROUND: Syphilis, a known major public health issue for soldiers during periods of conflict, is exacerbated in the Democratic Republic of Congo due to widespread sexual violence. However, there has been no previous study to determine the extent of this problem. Therefore, we determined the prevalence of syphilis among young demobilized soldiers. Methods: Screening of syphilis using the rapid plasma reagin test and the Treponema pallidum hemagglutination assay was conducted in three transit sites of soldier reintegration in 2005. Fischer Exact test was used to compare results. Results: The prevalence of syphilis was found to be 3.4%, with almost equal distribution in respect to sex, and location. Conclusion: Syphilis continues to be highly prevalent in demobilized child soldiers in Eastern Congo. Syphilis screening tests are recommended.
Conflict and health.Confl Health.2011 Sep 6;5(1):16. [Epub ahead of print]
ABSTRACT: BACKGROUND: Syphilis, a known major public health issue for soldiers during periods of conflict, is exacerbated in the Democratic Republic of Congo due to widespread sexual violence. However, there has been no previous study to determine the extent of this problem. Therefore, we determined
PMID 21896173

Further evaluation of the characteristics of Treponema pallidum-specific IgM antibody in syphilis serofast reaction patients.

Lin LR, Zheng WH, Tong ML, Fu ZG, Liu GL, Fu JG, Zhang DW, Yang TC, Liu LL.SourceCenter of Clinical Laboratory, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, 361004, China.
Diagnostic microbiology and infectious disease.Diagn Microbiol Infect Dis.2011 Sep 5. [Epub ahead of print]
Syphilis serofast reaction (SSR) is common in clinical work. From June 2005 to May 2009, 1208 syphilis patients were chosen for research by the Xiamen Center of Clinical Laboratory in China. Serologic tests were performed with toluidine red unheated serum test (TRUST) and Treponema pallidum particle
PMID 21899981

Japanese Journal

Prevalence of Treponema pallidum, Hepatitis B Virus and Hepatitis C Virus Infection in Non-hemophiliac Patients Infected with Human Immunodeficiency Virus in Japan

SAITA Mizue,NAITO Toshio,KATAYAMA Akiko,FUKUDA Hiroshi,ISONUMA Hiroshi,DAMBARA Takashi
日本エイズ学会誌 = The journal of AIDS research 12(1), 28-33, 2010-02-20
NAID 10026901904

下口唇に初期硬結を来した第1期梅毒の1例

小村豪,福岡修,鈴木政美
日本耳鼻咽喉科学会会報 113(9), 758-761, 2010
梅毒の中で陰部外初期硬結はその約半数が口腔粘膜に見られると言われ, その中でも口唇が最多とされる. 今回われわれは下口唇の初期硬結を来した梅毒患者を経験したので報告する. 本症例は54歳男性で口唇腫瘍の疑いにて近医皮膚科から紹介となった. 血液検査上STS, TPLA共に陽性であり, 梅毒と診断した. 治療はアモキシシリン1,500mg/日の4週投与を行い, 速やかに治癒した. 鑑別診断に上げられ …
NAID 130000798325

Related Pictures

★リンクテーブル★

国試過去問	「106D030」「083A070」
リンク元	「周産期感染症」「梅毒」「トレポネーマ属」「TORCH症候群」「梅毒トレポネーマ」
拡張検索	「Treponema pallidum hemagglutination test」「Treponema pallidum hemagglutmation test」「Treponema pallidum complement fixation test」
関連記事	「pallidum」

「106D030」

Treponema pallidum
Scientific classification
Domain:	Bacteria
Phylum:	Spirochaetes
Order:	Spirochaetales
Family:	Spirochaetaceae
Genus:	Treponema
Species:	T. pallidum
Binomial name
	Treponema pallidum; Schaudinn & Hoffmann, 1905

　　[★]

29歳の男性。排尿時痛を主訴に来院した。 14日前に性行為感染の機会があった。2日前から排尿時痛と漿液性の尿道分泌物とを自覚するようになったため受診した。外尿道口周囲に発赤を認めない。触診で陰嚢部に異常を認めない。直腸指診で前立腺に異常を認めない。尿所見:蛋白1+、糖(-)、潜血(-)、沈渣に赤血球1-5/1視野、白血球10-20/1視野。尿道分泌物のGram染色で細菌を認めない。
この疾患の原因として考えられるのはどれか。