Detection of Treponema pallidum by a Fluorescent Monoclonal Antibody Test

Definitive diagnosis of early syphilis currently requires darkfield microscopy and/or a newly reactive sérologie test for syphilis. The efficacy of dark-field microscopy depends on the availability of a microscope, the skill of the clinician in obtaining a specimen, and the expertise of the microsco...

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Veröffentlicht in:Sexually transmitted diseases 1987-07, Vol.14 (3), p.156-159
Hauptverfasser: ROMANOWSKI, BARBARA, FORSEY, ELAINE, PRASAD, ERROL, LUKEHART, SHEILA, TAM, MILTON, HOOK, EDWARD W.
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container_end_page 159
container_issue 3
container_start_page 156
container_title Sexually transmitted diseases
container_volume 14
creator ROMANOWSKI, BARBARA
FORSEY, ELAINE
PRASAD, ERROL
LUKEHART, SHEILA
TAM, MILTON
HOOK, EDWARD W.
description Definitive diagnosis of early syphilis currently requires darkfield microscopy and/or a newly reactive sérologie test for syphilis. The efficacy of dark-field microscopy depends on the availability of a microscope, the skill of the clinician in obtaining a specimen, and the expertise of the microscopist. Serologie diagnosis may be affected by the delay between the appearance of the primary chancre and the onset of sérologie reactivity. We used a pathogen-specific fluorescein-conjugated monoclonal antibody to examine lesion exudates from 128 consecutive patients and compared these data with results of dark-field microscopy, the rapid plasma reagin (RPR) test, and the fluorescent treponemal antibody-absorbed (FTA-Abs) test. The monoclonal antibody test demonstrated Treponema pallidum in 48 (73%) of 66 patients with infectious syphilis, while dark-field microscopy was positive for 52 (79%) of 66 patients. None of 62 patients without syphilis was positive by either test. The FTA-Abs test was reactive for 61 patients (92%) of the 66 with infectious syphilis. Thus the fluorescent monoclonal antibody test for detection of T. pallidum in direct smears is as sensitive and specific as dark-field microscopy for the diagnosis of infectious syphilis. It has the potential to provide a convenient, accurate means for definitive diagnosis of genital ulcer disease by health care personnel without ready access to dark-field microscopy.
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The efficacy of dark-field microscopy depends on the availability of a microscope, the skill of the clinician in obtaining a specimen, and the expertise of the microscopist. Serologie diagnosis may be affected by the delay between the appearance of the primary chancre and the onset of sérologie reactivity. We used a pathogen-specific fluorescein-conjugated monoclonal antibody to examine lesion exudates from 128 consecutive patients and compared these data with results of dark-field microscopy, the rapid plasma reagin (RPR) test, and the fluorescent treponemal antibody-absorbed (FTA-Abs) test. The monoclonal antibody test demonstrated Treponema pallidum in 48 (73%) of 66 patients with infectious syphilis, while dark-field microscopy was positive for 52 (79%) of 66 patients. None of 62 patients without syphilis was positive by either test. The FTA-Abs test was reactive for 61 patients (92%) of the 66 with infectious syphilis. 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source MEDLINE; Journals@Ovid Complete; JSTOR Archive Collection A-Z Listing
subjects Adult
Antibodies, Monoclonal
Biological and medical sciences
Female
Fluorescent Antibody Technique
General aspects
Human infectious diseases. Experimental studies and models
Humans
Infectious diseases
Male
Medical sciences
Original Articles
Syphilis Serodiagnosis - methods
title Detection of Treponema pallidum by a Fluorescent Monoclonal Antibody Test
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