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Identification of Treponema pallidum in tissues
Syphilis is caused by infection with the spirochete Treponema pallidum. Transmission of T pallidum occurs via penetration of the spirochetes through mucosal membranes and abrasions on epithelial surfaces. This test will identify T pallidum, however it also cross-reacts with other spirochetes.
This test does not include pathologist interpretation; only technical performance of the stain is performed. If an interpretation is required, order PATHC / Pathology Consultation for a full diagnostic evaluation or second opinion of the case.
The positive and negative controls are verified as showing appropriate immunoreactivity and documentation is retained at Mayo Clinic Rochester. If a control tissue is not included on the slide, a scanned image of the relevant quality control tissue is available upon request. Contact 855-516-8404.
Interpretation of this test should be performed in the context of the patient's clinical history and other diagnostic tests by a qualified pathologist.
Contamination and cross-reactivity with other microorganisms, including other spirochetes, may lead to nonspecific staining. Clinical and serologic correlation is recommended for diagnostic confirmation.
Age of a cut paraffin section can affect immunoreactivity. Stability thresholds vary widely among published literature and are antigen-dependent. Best practice is for paraffin sections to be cut within 6 weeks.
1. Muller H, Eisendle K, Brauninger W, Kutzner H, Cerroni L, Zelger B: Comparative analysis of immunohistochemistry, polymerase chain reaction and focus-floating microscopy for the detection of Treponema pallidum in mucocutaneous lesions of primary, secondary and tertiary syphilis. Br J Dermatol. 2011 Jul;165(1):50-60
2. Theel ES, Katz SS, Pillay A: Molecular and direct detection tests for Treponema pallidum subspecies pallidum: a review of the literature, 1964-2017. Clin Infect Dis. 2020 Jun 24;71(Supplement_1):S4-S12. doi: 10.1093/cid/ciaa176
3. Fukuda H, Takahashi M, Kato K, Oharaseki T, Mukai H: Multiple primary syphilis on the lip, nipple-areola and penis: An immunohistochemical examination of Treponema pallidum localization using an anti-T. pallidum antibody. J Dermatol. 2015 May;42(2):515-517