Isolation of Treponema pallidum from Juxta-articular Nodules

Abstract

The syphilitic nature of the juxta-articular nodules occasionally seen in syphilitic patients is generally accepted principally because of the prompt response of the lesions to arsphenamine therapy. Since the nodules are usually encountered in patients in the later stages of the infection, the failure to demonstrate organisms by the dark-field or in stained tissue sections is presumably due to their scarcity. Animal inoculation offers a more hopeful means of success and although the method has apparently not been widely used, one successful result has been reported 1 . This method was employed in 2 of the 5 cases of juxta-articular nodes in syphilitic patients seen in the Peiping Union Medical College 2 . One attempt was successful; the failure in the second case may have been due to the fact that arsphenamine had been administered 3 days before admission.

The patient gave a history of venereal exposure and a genital chancre 12 years before admission; the blood Wassermann and Kahn reactions were positive. There were several small firm, nontender nodules in the subcutaneous tissue below both elbows and over the great trochanters. One nodule (1.0 × 1.0 cm.), removed under local anesthesia, was finely emulsified with sterile normal saline. All the suspension was used for inoculation, 1.0 cc. being injected into the right testicle of 2 normal rabbits. In both animals, an orchitis developed 10 weeks after inoculation and the blood Wassermann reaction became positive. In one rabbit, Treponema pallidum were demonstrated in the material aspirated from the testicular lesion; a metastalic lesion of the uninoculated testicle developed 3 weeks after the primary orchitis was detected. Spirochetes were not seen in the material aspirated from the second rabbit which died from an intercurrent infection.