Authors
Damian Kadylak, Justyna Czarny-Kamm, Maciej Pastuszczak, Małgorzata Sokołowska-Wojdyło
Published in
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. Pages 109049. Aug 16, 2026. Epub Aug 16, 2026.
Abstract
To compare Treponema pallidum (TP) PCR positivity across anatomical sites and assess whether oropharyngeal sampling warrants prospective evaluation as an adjunct to serology in suspected early syphilis without suitable lesion material.
Retrospective cross-sectional study of 70 patients with serologically confirmed syphilis at a Polish STI clinic. Oropharyngeal, anorectal, and urogenital samples were analysed by clustered logistic regression adjusted for site, stage, and log₂ Venereal Disease Research Laboratory (VDRL) titre.
Among 171 samples, oropharyngeal positivity was highest (27/65, 41.5%). The adjusted model included 168 samples from 69 patients. Compared with urogenital sampling, oropharyngeal sampling had higher odds of positivity (adjusted odds ratio [aOR], 3.37; 95% CI, 1.50-7.55; P = .003). Late/unknown-duration syphilis had lower odds (aOR, 0.10; 95% CI, 0.03-0.35; P < .001), whereas each twofold VDRL increase raised the odds (aOR, 1.38; 95% CI, 1.06-1.78; P = .015). Overall, 64.6% of positive samples lacked local symptoms and objective findings.
Oropharyngeal positivity was frequent, particularly in early syphilis and at clinically normal sites. Oropharyngeal sampling warrants prospective evaluation as an adjunct to serology when lesion material is unavailable. Findings do not support routine screening of asymptomatic contacts or high-risk populations, HIV-specific testing, or serology replacement.
PMID:
42604652
Bibliographic data and abstract were imported from PubMed on 17 Aug 2026.
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