Laboratory diagnosis and interpretation of tests for syphilis.

Larsen, Sandra A.; Steiner, Bret; Rudolph, Andandrew H.

doi:10.1128/cmr.8.1.1-21.1995

Cited by 166 publications

(307 citation statements)

References 5 publications

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“…10 A quantitative VDRL is 78% sensitive in primary syphilis, and 100% and 95% sensitive in secondary disease and latent disease, respectively; it is 98% specific. 11 The VDRL is used to stage syphilis and monitor response to treatment. A lumbar puncture may be indicated if there are signs of neurological involvement but CSF testing cannot reliably exclude neurosyphilis.…”

Section: Discussionmentioning

confidence: 99%

Tertiary syphilis and Kaposi sarcoma mistaken for systemic sarcoidosis in an HIV-negative patient

Anyasodor

Bewley

2015

Br J Dermatol

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We describe a case of an HIV-negative man who was mistakenly diagnosed as having systemic sarcoidosis, which led to a delay in diagnosing tertiary syphilis and Kaposi sarcoma (KS). The patient presented initially with scrotal swelling and leg oedema. Initial blood tests were unremarkable and HIV testing was negative. The patient then developed unilateral limb weakness. Computed tomography showed lung lesions and hilar lymphadenopathy, while magnetic resonance imaging showed an increased signal in the cervical cord. Serum angiotensin-converting enzyme was raised, and a diagnosis of sarcoidosis was made and the patient started on steroids. Subsequently, his clinical symptoms and radiological abnormalities improved. However, he then developed progressive neurological deficits over several weeks, together with uveitis and cutaneous lesions. A uveitis screen showed a raised venereal disease research laboratory test titre and the cause of his multisystemic symptoms was revisited. He was diagnosed with tertiary syphilis and treated with antibiotics. Dermatologists reviewed the skin lesions and diagnosed KS, which was confirmed with biopsies. The patient's neurological deficit remains. Syphilis should be considered in the differential diagnosis of any patient presenting with neurological problems, skin lesions or symptoms affecting multiple systems. Co-existing KS presented an extra therapeutic challenge in this case.

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Section: Discussionmentioning

confidence: 99%

Tertiary syphilis and Kaposi sarcoma mistaken for systemic sarcoidosis in an HIV-negative patient

Anyasodor

Bewley

2015

Br J Dermatol

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“…Nach erfolgreicher Therapie wird der Cardiolipin-Antikörperbefund in der Regel negativ. Falsch-positive Reaktionen sind assoziiert mit anderen bakteriellen und viralen Infektionen, Autoimmunerkrankungen und Malignomen (Bundesgesundheitsamt 1979, Larsen et al 1995, MIQ 2001, Müller & Hagedorn 1998). (Larsen et al 1995, MIQ 2001, Müller & Hagedorn 1998 (Backhouse & Nesteroff 2001, Larsen et al 1995, MIQ 2001, Müller & Hagedorn 1998 (Backhouse & Nesteroff 2001, MIQ 2001, Müller Hagedorn 1998, Schmidt 2000.…”

Section: Serologische Tests 331 Nicht-treponemenspezifische Antikörunclassified

“…der Behandlungsbedürftigkeit. Bei unbehandelten Patienten gelten ein positiver Lipoidantikörperbefund und /oder ein positiver spezifischer IgM-Antikörperbefund als Hinweis auf Behandlungsbedürftigkeit (Bundesgesundheitsamt 1979, Larsen et al 1995, MIQ 2001, Müller & Hagedorn 1998, Singh & Romanowski 1999. Müller Hagedorn 1998, Singh & Romanowski 1999.…”

Section: Serologische Grunddiagnostikunclassified

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Syphilis. Leitlinie der Deutschen STD Gesellschaft zur Diagnostik und Therapie der Syphilis

Schöfer

Brockmeyer²,

Hagedorn³

et al. 2006

J Deutsche Derma Gesell

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“…9 Especially for herpes simplex virus and Treponema pallidum detection, cell culture shows low-sensitivity and long turnaround time, making this assay clinically useless. 10,11 However, over the past two decades, molecular testing has been widely used to detect pathogens associated with STIs. Compared with traditional methods, molecular tests, such as PCR, real-time PCR, multiplex PCR, and microarray, have rapid turnaround times and superior sensitivities.…”

Section: Introductionmentioning

confidence: 99%

<p>Simultaneous detection of eleven sexually transmitted agents using multiplexed PCR coupled with MALDI-TOF analysis</p>

Xiu¹,

Zhang²,

Li³

et al. 2019

IDR

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PurposeSexually transmitted infections (STIs), representing a major global health problem, are caused by different microbes, including bacteria, viruses, and protozoa. Unfortunately, infections of different sexually transmitted pathogens often present similar clinical symptoms, so it is almost impossible to distinguish them clinically. Therefore, the aim of the current study was to develop a sensitive, multitarget, and high-throughput method that can detect various agents responsible for STIs.MethodsWe developed and tested a 23-plex PCR coupled with matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) assay (sexually transmitted infection-mass spectrometry, STI-MS) that simultaneously targets 11 different agents, including 8 most common clinical pathogens related to STIs (HSV-1, HSV-2, Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, Trichomonas vaginalis, Mycoplasma genitalium, and Haemophilus ducreyi) and 3 controversial microorganisms as pathogens (Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum).ResultsThe results showed that the STI-MS approach can accurately detect the expected agents, without cross-reaction with other organisms. The limit of detection of each STI-MS assay was ranged from 1.739 to 10.009 copies/reaction, using probit analyses. The verification rate for each target organism of the STI-MS ranged from a minimum of 89.3% to a maximum of 100%, using conventional assays and ultrasensitive digital PCR to confirm the STI-MS-positive results. To further evaluate the clinical performance of this assay, 241 clinical specimens (124 urethral/cervical swabs and 117 urine) were tested in parallel using the STI-MS assay and monoplex real-time PCR for each agent. The overall validation parameters of STI-MS were extremely high including sensitivity (from 85.7% to 100%), specificity (from 92.3% to 100%), PPV (from 50% to 100%), and NPV (from 99.1% to 100%) for each target.ConclusionSTI-MS is a useful high-throughput screening tool for detecting mixed infections of STIs and has great potential for application in large-scale epidemiological programs for specific microorganisms of STI.

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Laboratory diagnosis and interpretation of tests for syphilis.

Cited by 166 publications

References 5 publications

Tertiary syphilis and Kaposi sarcoma mistaken for systemic sarcoidosis in an HIV-negative patient

Tertiary syphilis and Kaposi sarcoma mistaken for systemic sarcoidosis in an HIV-negative patient

Syphilis. Leitlinie der Deutschen STD Gesellschaft zur Diagnostik und Therapie der Syphilis

<p>Simultaneous detection of eleven sexually transmitted agents using multiplexed PCR coupled with MALDI-TOF analysis</p>

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