Dark ground microscopy and treponemal serological tests in the diagnosis of early syphilis
Objectives: To evaluate the use of dark ground microscopy (DGM) and treponemal serological tests in the diagnosis of primary (PS) and secondary (SS) syphilis. Methods: A retrospective case note review of patients with early syphilis who attended our department between January 2001 and December 2002....
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description | Objectives: To evaluate the use of dark ground microscopy (DGM) and treponemal serological tests in the diagnosis of primary (PS) and secondary (SS) syphilis. Methods: A retrospective case note review of patients with early syphilis who attended our department between January 2001 and December 2002. Data were collected on demographics, results of treponemal serology and DGM. Results: 50 individuals had PS and 36 individuals had SS. DGM was performed in 31/50 (62%) of PS cases and this was positive in 97%. In 17 (34%) cases of PS, treponemal EIA was negative initially. DGM was performed on 13 of these, all of which were positive. Therefore, EIA had a sensitivity of 57% when compared to DGM. In 27 patients where EIA-IgM was performed, this was positive in 22 (81%), of which 12 were EIA negative on initial screening. All SS cases had positive EIA. DGM was performed in 19/36 (52%) of SS cases and was positive in 16/19—that is, a sensitivity of 84% when compared to EIA. The major reason why DGM was not performed in the cases of PS was that herpes was the presumed diagnosis and in SS the rash was attributed to other causes. Conclusions: DGM is a rapid and sensitive test while EIA takes time for results and is less sensitive in PS. EIA-IgM is a useful adjunct in PS. DGM allows immediate diagnosis, treatment, and partner notification preventing further transmission. Genitourinary medicine clinics should have trained staff to perform DGM on all anogenital ulcers and suspected syphilitic lesions. |
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Methods: A retrospective case note review of patients with early syphilis who attended our department between January 2001 and December 2002. Data were collected on demographics, results of treponemal serology and DGM. Results: 50 individuals had PS and 36 individuals had SS. DGM was performed in 31/50 (62%) of PS cases and this was positive in 97%. In 17 (34%) cases of PS, treponemal EIA was negative initially. DGM was performed on 13 of these, all of which were positive. Therefore, EIA had a sensitivity of 57% when compared to DGM. In 27 patients where EIA-IgM was performed, this was positive in 22 (81%), of which 12 were EIA negative on initial screening. All SS cases had positive EIA. DGM was performed in 19/36 (52%) of SS cases and was positive in 16/19—that is, a sensitivity of 84% when compared to EIA. The major reason why DGM was not performed in the cases of PS was that herpes was the presumed diagnosis and in SS the rash was attributed to other causes. Conclusions: DGM is a rapid and sensitive test while EIA takes time for results and is less sensitive in PS. EIA-IgM is a useful adjunct in PS. DGM allows immediate diagnosis, treatment, and partner notification preventing further transmission. Genitourinary medicine clinics should have trained staff to perform DGM on all anogenital ulcers and suspected syphilitic lesions.</description><identifier>ISSN: 1368-4973</identifier><identifier>EISSN: 1472-3263</identifier><identifier>DOI: 10.1136/sti.2003.008821</identifier><identifier>PMID: 15459413</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Bacterial diseases ; Bacterial diseases of the genital system ; Biological and medical sciences ; Cohort Studies ; dark ground microscopy ; DFA-Tp ; DGM ; direct fluorescent antibody ; EIA ; enzyme immunoassay ; Female ; General aspects ; Human bacterial diseases ; Human infectious diseases. Experimental studies and models ; Humans ; Infections ; Infectious diseases ; Laboratories ; Male ; Medical diagnosis ; Medical sciences ; Medicine ; Microscopy ; Microscopy - methods ; Microscopy - standards ; Original ; Patients ; PCR ; polymerase chain reaction ; primary syphilis ; rapid plasma reagin ; Retrospective Studies ; RPR ; secondary syphilis ; Sensitivity and Specificity ; Syphilis ; Syphilis - diagnosis ; Syphilis Serodiagnosis - methods ; Syphilis Serodiagnosis - standards ; Treponema pallidum - isolation & purification ; treponemal serological tests</subject><ispartof>Sexually transmitted infections, 2004-10, Vol.80 (5), p.411-414</ispartof><rights>Copyright 2004 Sexually Transmitted Infections</rights><rights>2005 INIST-CNRS</rights><rights>Copyright: 2004 Copyright 2004 Sexually Transmitted Infections</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b551t-c13def88978683c06c73cd136f5070608b359151f54474a698b50341aaa1a4253</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1744899/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1744899/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16206270$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15459413$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wheeler, H L</creatorcontrib><creatorcontrib>Agarwal, S</creatorcontrib><creatorcontrib>Goh, B T</creatorcontrib><title>Dark ground microscopy and treponemal serological tests in the diagnosis of early syphilis</title><title>Sexually transmitted infections</title><addtitle>Sex Transm Infect</addtitle><description>Objectives: To evaluate the use of dark ground microscopy (DGM) and treponemal serological tests in the diagnosis of primary (PS) and secondary (SS) syphilis. Methods: A retrospective case note review of patients with early syphilis who attended our department between January 2001 and December 2002. Data were collected on demographics, results of treponemal serology and DGM. Results: 50 individuals had PS and 36 individuals had SS. DGM was performed in 31/50 (62%) of PS cases and this was positive in 97%. In 17 (34%) cases of PS, treponemal EIA was negative initially. DGM was performed on 13 of these, all of which were positive. Therefore, EIA had a sensitivity of 57% when compared to DGM. In 27 patients where EIA-IgM was performed, this was positive in 22 (81%), of which 12 were EIA negative on initial screening. All SS cases had positive EIA. DGM was performed in 19/36 (52%) of SS cases and was positive in 16/19—that is, a sensitivity of 84% when compared to EIA. The major reason why DGM was not performed in the cases of PS was that herpes was the presumed diagnosis and in SS the rash was attributed to other causes. Conclusions: DGM is a rapid and sensitive test while EIA takes time for results and is less sensitive in PS. EIA-IgM is a useful adjunct in PS. DGM allows immediate diagnosis, treatment, and partner notification preventing further transmission. Genitourinary medicine clinics should have trained staff to perform DGM on all anogenital ulcers and suspected syphilitic lesions.</description><subject>Bacterial diseases</subject><subject>Bacterial diseases of the genital system</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>dark ground microscopy</subject><subject>DFA-Tp</subject><subject>DGM</subject><subject>direct fluorescent antibody</subject><subject>EIA</subject><subject>enzyme immunoassay</subject><subject>Female</subject><subject>General aspects</subject><subject>Human bacterial diseases</subject><subject>Human infectious diseases. Experimental studies and models</subject><subject>Humans</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Microscopy</subject><subject>Microscopy - methods</subject><subject>Microscopy - standards</subject><subject>Original</subject><subject>Patients</subject><subject>PCR</subject><subject>polymerase chain reaction</subject><subject>primary syphilis</subject><subject>rapid plasma reagin</subject><subject>Retrospective Studies</subject><subject>RPR</subject><subject>secondary syphilis</subject><subject>Sensitivity and Specificity</subject><subject>Syphilis</subject><subject>Syphilis - diagnosis</subject><subject>Syphilis Serodiagnosis - methods</subject><subject>Syphilis Serodiagnosis - standards</subject><subject>Treponema pallidum - isolation & purification</subject><subject>treponemal serological tests</subject><issn>1368-4973</issn><issn>1472-3263</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkktv1DAUhSMEoqWwZocsIbpAytTvxwYJTaEgjcoGWMzGchxnxkMSBztBzL_HUUYtsOnK17qfj869x0XxEsEVQoRfpdGvMIRkBaGUGD0qzhEVuCSYk8e5JlyWVAlyVjxL6QAh5IKpp8UZYpQpish5sb028QfYxTD1Nei8jSHZMByBydcxuiH0rjMtSC6GNuy8zfXo0piA78G4d6D2ZteH5BMIDXAmtkeQjsPetz49L540pk3uxem8KL59_PB1_ancfLn5vH6_KSvG0FhaRGrXSKmE5JJYyK0gts7WGwYF5FBWhCnEUMMoFdRwJSsGCUXGGGQoZuSieLfoDlPVudq6foym1UP0nYlHHYzX_3Z6v9e78EsjQalUKgtcngRi-Dnl6XTnk3Vta3oXpqQ5VwRjTB8EkcgZII4y-Po_8BCm2OctzMyMKTXLXS3UvPUUXXPnGUE9x6tzvHqOVy_x5hev_h71nj_lmYE3J8CknFUTTW99uuc4hhwLmLly4Xwa3e-7fv4LmgsimL79vtYbdLvd3OCt5pl_u_BVd3jQ5R8FjMnZ</recordid><startdate>20041001</startdate><enddate>20041001</enddate><creator>Wheeler, H L</creator><creator>Agarwal, S</creator><creator>Goh, B T</creator><general>BMJ Publishing Group Ltd</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><general>BMJ Group</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20041001</creationdate><title>Dark ground microscopy and treponemal serological tests in the diagnosis of early syphilis</title><author>Wheeler, H L ; Agarwal, S ; Goh, B T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b551t-c13def88978683c06c73cd136f5070608b359151f54474a698b50341aaa1a4253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Bacterial diseases</topic><topic>Bacterial diseases of the genital system</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>dark ground microscopy</topic><topic>DFA-Tp</topic><topic>DGM</topic><topic>direct fluorescent antibody</topic><topic>EIA</topic><topic>enzyme immunoassay</topic><topic>Female</topic><topic>General aspects</topic><topic>Human bacterial diseases</topic><topic>Human infectious diseases. Experimental studies and models</topic><topic>Humans</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Laboratories</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Microscopy</topic><topic>Microscopy - methods</topic><topic>Microscopy - standards</topic><topic>Original</topic><topic>Patients</topic><topic>PCR</topic><topic>polymerase chain reaction</topic><topic>primary syphilis</topic><topic>rapid plasma reagin</topic><topic>Retrospective Studies</topic><topic>RPR</topic><topic>secondary syphilis</topic><topic>Sensitivity and Specificity</topic><topic>Syphilis</topic><topic>Syphilis - diagnosis</topic><topic>Syphilis Serodiagnosis - methods</topic><topic>Syphilis Serodiagnosis - standards</topic><topic>Treponema pallidum - isolation & purification</topic><topic>treponemal serological tests</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wheeler, H L</creatorcontrib><creatorcontrib>Agarwal, S</creatorcontrib><creatorcontrib>Goh, B T</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Sexually transmitted infections</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wheeler, H L</au><au>Agarwal, S</au><au>Goh, B T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dark ground microscopy and treponemal serological tests in the diagnosis of early syphilis</atitle><jtitle>Sexually transmitted infections</jtitle><addtitle>Sex Transm Infect</addtitle><date>2004-10-01</date><risdate>2004</risdate><volume>80</volume><issue>5</issue><spage>411</spage><epage>414</epage><pages>411-414</pages><issn>1368-4973</issn><eissn>1472-3263</eissn><abstract>Objectives: To evaluate the use of dark ground microscopy (DGM) and treponemal serological tests in the diagnosis of primary (PS) and secondary (SS) syphilis. Methods: A retrospective case note review of patients with early syphilis who attended our department between January 2001 and December 2002. Data were collected on demographics, results of treponemal serology and DGM. Results: 50 individuals had PS and 36 individuals had SS. DGM was performed in 31/50 (62%) of PS cases and this was positive in 97%. In 17 (34%) cases of PS, treponemal EIA was negative initially. DGM was performed on 13 of these, all of which were positive. Therefore, EIA had a sensitivity of 57% when compared to DGM. In 27 patients where EIA-IgM was performed, this was positive in 22 (81%), of which 12 were EIA negative on initial screening. All SS cases had positive EIA. DGM was performed in 19/36 (52%) of SS cases and was positive in 16/19—that is, a sensitivity of 84% when compared to EIA. The major reason why DGM was not performed in the cases of PS was that herpes was the presumed diagnosis and in SS the rash was attributed to other causes. Conclusions: DGM is a rapid and sensitive test while EIA takes time for results and is less sensitive in PS. EIA-IgM is a useful adjunct in PS. DGM allows immediate diagnosis, treatment, and partner notification preventing further transmission. Genitourinary medicine clinics should have trained staff to perform DGM on all anogenital ulcers and suspected syphilitic lesions.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>15459413</pmid><doi>10.1136/sti.2003.008821</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Bacterial diseases Bacterial diseases of the genital system Biological and medical sciences Cohort Studies dark ground microscopy DFA-Tp DGM direct fluorescent antibody EIA enzyme immunoassay Female General aspects Human bacterial diseases Human infectious diseases. Experimental studies and models Humans Infections Infectious diseases Laboratories Male Medical diagnosis Medical sciences Medicine Microscopy Microscopy - methods Microscopy - standards Original Patients PCR polymerase chain reaction primary syphilis rapid plasma reagin Retrospective Studies RPR secondary syphilis Sensitivity and Specificity Syphilis Syphilis - diagnosis Syphilis Serodiagnosis - methods Syphilis Serodiagnosis - standards Treponema pallidum - isolation & purification treponemal serological tests |
title | Dark ground microscopy and treponemal serological tests in the diagnosis of early syphilis |
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