Disseminated Syphilis Caused by Two Recombining Treponema pallidum Strains
Abstract
- This Correspondence describes a rare and complex case of disseminated syphilis in a man with uncontrolled HIV infection who was coinfected with two distinct strains of Treponema pallidum—the SS14 and Nichols clades. Genomic sequencing of gastric and colon biopsy samples revealed a mosaic of genetic recombination between the strains, including transfer of penicillin-binding protein alleles and antigen-encoding gene segments. Despite syphilis typically being genetically conserved, this case demonstrates how recombination during coinfection can drive unexpected genomic variation, potentially impacting virulence, diagnostic accuracy, or treatment efficacy. The findings highlight the role of molecular epidemiology in detecting emerging T. pallidum variants and the evolutionary flexibility of this pathogen amid a rising syphilis epidemic.
Keywords:
syphilis
recombination
Treponema pallidum
coinfection
Nichols clade
SS14 clade
HIV
antimicrobial resistance
Article Document
1 / 1
100%