Diagnóstico de la infección por Treponema pallidum en pacientes con sífi lis temprana y neurosífi lis mediante reacción de la polimerasa en cadena Patricia García C., Bruno Grassi C., Félix Fich S., Aurelio Salvo L., Luis Araya C., Fernando Abarzúa C., Julia Soto M., Helena Poggi M., Marcela Lagos L., Patricia Vásquez T., Eugenia P. León C., Carlos Pérez C. y Aniela Wozniak B. Laboratory diagnosis of Treponema pallidum infection in patients with early syphilis and neurosyphilis through a PCR-based testSyphilis is a sexually transmitted disease caused by Treponema pallidum. The diagnosis is based mainly in clinical presentation and non-specifi c assays. PCR-based diagnosis has been suggested as an attractive alternative method. The aim of this study was the validation of a PCR-based test for the diagnosis of early syphilis (ES) and neurosyphilis (NS). Clinical samples of mucocutaneous lesions and cerebrospinal fl uid (CSF) specimens from patients previously diagnosed for ES and NS respectively using an enlarged gold standard, were tested by PCR. The reaction was done using primers targeting the tpN47gene. Twenty out of 21 mucocutaneous samples from patients diagnosed with ES were positive by PCR, with a clinical sensitivity of 95%. Four out of 8 CSF samples from patients previously diagnosed with NS were positive by PCR, with a clinical sensitivity of 50%. The clinical specifi city for both ES and NS was 100%. The PCR sensitivity and specifi city for mucocutaneous samples allowed us to implement this assay in our laboratory for routine diagnosis. Although the sensitivity of the PCR in CSF was low, it may be useful to support clinical diagnosis.Key words: Treponema pallidum, syphilis, polymerase chain reaction, diagnosis. Palabras clave: Treponema pallidum, sífi lis, reacción de polimerasa en cadena, diagnóstico. Pontificia Universidad Católica de ChileDepartamento de Laboratorios Clínicos:Laboratorio de Microbiología (PGC, EPLC, AWB).Unidad Docente de Apoyo:División Ginecología y Obstetricia (FAC). Laboratorio de Biología Molecular(JSM, HPM, MLL).Departamento de Medicina Interna (CPC). Escuela de Medicina (BGC).Hospital San Juan de Dios, Santiago. Servicio de Neurología (LAC). Unidad de Infectología (PVT).Hospital Sótero Del Río, Santiago. Introducción L a sífi lis es una enfermedad de transmisión sexual, de carácter crónico, que evoluciona en fases clíni-cas: sífi lis primaria, secundaria, latente y terciaria. El agente etiológico de la sífi lis, Treponema pallidum, es una espiroqueta no cultivable 1 . Durante los últimos años se han registrado brotes de esta enfermedad en varios países, incluso en naciones desarrolladas como Canadá (National Infectious Disease Examiner.com -Syphilis spikes in Alberta, Canada-health offi cials looking for solutions. URL: http://www.examiner.com). En Alberta, una provincia de Canadá, existe una gran preocupación debido a que el número de casos de sífi lis en 1999 fue dos y en 2009 ascendió a 267 casos, probablemente debido a la promiscuidad sexual de las personas, principalmente ...
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