Vesiculobullous syphilis: a case involving an unusual cutaneous manifestation of secondary syphilis.

The recent resurgence of syphilis mandates that clinicians maintain a heightened suspicion for Treponema infection, and that they be aware of the variety of cutaneous presentations that may mimic eczema, psoriasis, drug eruption, erythema multiforme, lichen planus, tinea versicolor, seborrheic dermatitis, mycosis fungoides, or other lichenoid lesions. In this report, we describe an unusual case of secondary syphilis in an adult woman, and briefly review the wide array of syphilitic dermopathy that could present to the foot and ankle surgeon.

Chronic cough associated with subacute bacterial endocarditis.

Although the literature on subacute bacterial endocarditis from both the preantibiotic and antibiotic eras mentions cough as a symptom, neither bacteremia nor endocarditis is listed in reviews on chronic cough. Herein we describe a 74-year-old man who underwent an extensive workup as an outpatient because of chronic cough of 7 months' duration. Chest roentgenography, chest and sinus computed tomography, fiberoptic bronchoscopy, gallium scan, transthoracic echocardiography, and other studies revealed no apparent cause for his nonproductive cough.

Multiplex PCR for identification of methicillin-resistant staphylococci in the clinical laboratory.

A multiplex PCR assay for detection of the staphylococcal mecA gene (the structural gene for penicillin-binding protein 2a) was compared with agar dilution and disk diffusion susceptibility test methods for identifying methicillin resistance. The multiplex PCR assay combined two primer sets (mecA and 16S rRNA) in a single reaction. A total of 500 staphylococcal isolates (228 isolates of Staphylococcus aureus and 272 isolates of coagulase-negative staphylococci) from clinical specimens were studied.

Chemiluminescent universal probe for bacterial ribotyping.

We describe a novel procedure for direct covalent coupling of horseradish peroxidase to rRNA and ribotyping by using enhanced chemiluminescence. Compared with their 32P-end-labeled counterparts, chemiluminescent rRNA probes are stable and easy to synthesize and provide results as good as or superior to those obtained with isotopic labeling. Direct chemiluminescent labeling of Escherichia coli rRNA produces a sensitive, universal probe suitable for clinical laboratory use in the investigation of nosocomial outbreaks.