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Objective: This paper aims at investigating the possible existence of isotopic offsets in δ 13 C col and δ 15 N col values in relation to tertiary syphilis., Material: Based on materials from the 19th c. A.D. deriving from the pathological-anatomical reference collection (the Jedlička collection) of the National Museum in Prague (Czech Republic), a comparative approach of ten individuals with syphilis and nine without the disease was undertaken., Methods: Bone powder samples were defatted according to the protocol of Liden et al. (1995). Bone collagen was extracted following the protocol of Bocherens et al. (1991)., Results: Our results show that individuals with syphilis have lower δ 13 C col values than individuals without the disease; the observed difference between the two groups is about 0.3-0.4‰, which is relatively small but still meaningful. However, no difference between δ 15 N col values of the two groups has been noticed., Conclusions: Either diets prescribed by physicians to syphilitic patients or nutritional stress caused by cyclic appetite disturbance due to the disease itself or the administered medical treatment appeared to be possible explanations of the observed isotopic pattern. Overall, the response of the two isotopic proxies could argue for relatively limited nutritional restrictions., Significance: This is the first study examining bone collagen isotopic response to syphilis based on clinically documented human skeletal materials., Limitations: The sample sizes are relatively small and cautiousness must be taken regarding the interpretations of the data., Suggestions for Further Research: Compound-specific stable isotope investigations and analysis of mercury content could be helpful to better understand the observed isotopic effects., (Copyright © 2019 Elsevier Inc. All rights reserved.)

A recently introduced Multilocus Sequence Typing scheme for Treponema pallidum subsp. pallidum was applied to clinical samples collected from 2004 to 2017 from the two largest cities (Prague and Brno) in the Czech Republic. Altogether, a total of 675 samples were tested in this study and 281 of them were found PCR-positive for treponemal DNA and typeable. Most of the typed samples (n = 281) were swabs from primary or secondary syphilis lesions (n = 231), and only a minority were whole blood or tissue samples (n = 50). Swab samples from patients with rapid plasma regain (RPR) values of 1-1024 were more frequently PCR-positive (84.6%) compared to samples from patients with non-reactive RPR test (46.5%; p-value = 0.0001). Out of 281 typeable samples, 136 were fully-typed at all TP0136, TP0548, and TP0705 loci. Among the fully and partially typed samples, 25 different allelic profiles were identified. Altogether, eight novel allelic variants were found among fully (n = 5) and partially (n = 3) typed samples. The distribution of TPA allelic profiles identified in the Czech Republic from 2004 to 2017 revealed a dynamic character with allelic profiles disappearing and emerging over time. While the number of samples with the A2058G mutation was seen to increase (86.7% in 2016/2017), the number of samples harboring the A2059G mutation was found to have decreased over time (3.3% in 2016/2017). In addition, we found several allelic profile associations with macrolide resistance or susceptibility, the gender of patients, as well as patient residence., Competing Interests: The authors have declared that no competing interests exist.

Syphilis is a treponematosis clinically characterized by a primary lesion, a secondary rash affecting the skin and the mucous membranes and late lesions affecting cardiovascular and central nervous systems, viscera and bones. Off all the skeletal lesions, the most characteristic are those of the skull, most commonly affecting frontal and parietal bones and nasal and palatal region. The collection of 647 adult skulls of both sexes and 98 child and adolescent skulls from the "Broumov Ossuary" (13th - 18th century) was examined for the presence of the bone syphilis lesions. Seven cases of the gummatous lesions were observed among adult skulls. In the child skulls, three suspect findings of the congenital syphilis were diagnosed.

Background: For several decades the clinical picture of all stages of syphilis has been assumed to be immutable. The aim of the study was to describe the real spectrum of cutaneous and mucosal manifestations and organ changes and to ascertain whether the incidence of the disease has an increasing trend., Methods and Results: The studied group included 92 patients (44 males, 48 females, average was 31.3 years) diagnosed in years 1992 to 1998 at our clinics. The diagnose was confirmed by a microscopic and/or serologic examination. Number of patients with the primary syphilis increased more than twice (1992 versus 1997), incidence of newly registered manifestations of the secondary syphilis has also increased (1996 to 1998), number of hospitalised patients in the stadium of syphilis latens increased at least twice (1992 versus 1996). Higher was the number of proven cases in pregnant patients: number of dead births increased twice, inborn forms of syphilis were three times more frequent. Among the newly described clinical forms the specific gastritis and specific uveitis were diagnosed. In immunosuppressed patients forms of lues maligna and the blue toes syndrome were identified. However, those forms were not diagnosed among our group of studied patients., Conclusions: During the last 10 years a significant increase of incidence of syphilis was reported in the population of Czech Republic. Such dangerous and almost explosive rise of new cases has been accompanied with increased number of inborn forms and with the occurrence of new clinical manifestations, namely in immunosuppressed patients.