Serological tests for syphilis

Shah, Dhiral; Marfatia, Yogesh S

doi:10.4103/ijstd.ijstd_86_19

Cited by 11 publications

(5 citation statements)

References 9 publications

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“…Histopathological examination is also necessary if atypical lesions are found on a patient with secondary syphilis. 4 , 17 The structure of the epidermis tend to be normal or hyperplastic with parakeratosis or acanthosis. 1 , 4 Infiltration of plasma cells, lymphocytes, or histiocytes may be found on the dermis.…”

Section: Discussionmentioning

confidence: 99%

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Generalized Asymptomatic Nodulo-Ulcerative Lesions Without Systemic Symptoms in a Secondary Syphilis Patient Co-Infected with HIV

Maharani,

Nugraha,

Sutedja

et al. 2023

CCID

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Syphilis is a sexually-transmitted disease with various clinical stages. Secondary syphilis manifestations may mimic other skin lesions. Patient co-infected with Human Immunodeficiency Virus (HIV), with CD4 cell counts of 200-499 cells/mm 3 , often manifests an atypical cutaneous lesion, which may also occur as nodular or ulcerative lesions. Generalized nodulo-ulcerative lesions without systemic symptoms in secondary syphilis patients with HIV co-infection are rarely reported. A 22-year-old man presented with generalized asymptomatic multiple erythematous papules and plaques with scales, as well as nodular and nodulo-ulcerative lesions on the trunk, both arms, and both legs. His lesions spread progressively without the presence of any prodromal symptoms or adenopathy. He was previously diagnosed with HIV and is currently on antiretroviral medications, with a CD4 cell count of 388 cells/ μL. His venereal disease research laboratories (VDRL) result was reactive (titer of 1:256). His Treponema pallidum hemagglutination assay (TPHA) result was also reactive (titer of 1:10,240). A skin biopsy was performed from the nodulo-ulcerative lesion on his back. Hematoxylin-eosin staining revealed a hyperplastic epidermis, a massive influx of plasma cells, and lymphocyte infiltration into the deep dermis, especially in the peri-adnexal, peri-vascular, and peri-muscular regions. The patient was diagnosed with secondary syphilis with HIV co-infection. He had no previous history of drug allergy. A single dose of 2.4 million units of benzathine penicillin G was administered. Almost all the lesions became hyperpigmented macules after two weeks and resolved completely after one month. His VDRL titer declined to 1:32 after three months. The various atypical lesions of secondary syphilis may lead to misdiagnosis and delayed treatment. The presence of multiple asymptomatic nodulo-ulcerative lesion without prodromal symptoms may indicate the presence of secondary syphilis, notably in patients co-infected with HIV. Therefore, knowledge of atypical cutaneous manifestations of secondary syphilis is warranted in order to treat patients accordingly.

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Section: Discussionmentioning

confidence: 99%

“…1,2,4 The TPHA test will confirm the diagnosis of treponemal infection, whereas the VDRL test is performed to determine therapeutic response. 2,17 The patient in this case was reactive to both TPHA and VDRL, with a history of skin lesions, suggestive of secondary syphilis. The VDRL titer was also used to evaluate the therapeutic response in this patient.…”

mentioning

confidence: 82%

Generalized Asymptomatic Nodulo-Ulcerative Lesions Without Systemic Symptoms in a Secondary Syphilis Patient Co-Infected with HIV

Maharani,

Nugraha,

Sutedja

et al. 2023

CCID

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“…Furthermore, it is also possible to observe false-positive results in patients with an autoimmune condition, such as systemic lupus erythematosus, with other infectious diseases, such as brucellosis, or even in pregnancy ( 15 ). As syphilis shares several clinical manifestations and clinical characteristics with other treponemal and non-treponemal diseases, a safe clinical diagnosis is necessary, always performed by well-prepared and highly accurate laboratory tests ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

Computational methods applied to syphilis: where are we, and where are we going?

Albuquerque,

Fernandes,

Barbalho

et al. 2023

Front. Public Health

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Syphilis is an infectious disease that can be diagnosed and treated cheaply. Despite being a curable condition, the syphilis rate is increasing worldwide. In this sense, computational methods can analyze data and assist managers in formulating new public policies for preventing and controlling sexually transmitted infections (STIs). Computational techniques can integrate knowledge from experiences and, through an inference mechanism, apply conditions to a database that seeks to explain data behavior. This systematic review analyzed studies that use computational methods to establish or improve syphilis-related aspects. Our review shows the usefulness of computational tools to promote the overall understanding of syphilis, a global problem, to guide public policy and practice, to target better public health interventions such as surveillance and prevention, health service delivery, and the optimal use of diagnostic tools. The review was conducted according to PRISMA 2020 Statement and used several quality criteria to include studies. The publications chosen to compose this review were gathered from Science Direct, Web of Science, Springer, Scopus, ACM Digital Library, and PubMed databases. Then, studies published between 2015 and 2022 were selected. The review identified 1,991 studies. After applying inclusion, exclusion, and study quality assessment criteria, 26 primary studies were included in the final analysis. The results show different computational approaches, including countless Machine Learning algorithmic models, and three sub-areas of application in the context of syphilis: surveillance (61.54%), diagnosis (34.62%), and health policy evaluation (3.85%). These computational approaches are promising and capable of being tools to support syphilis control and surveillance actions.

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“…While a simple solution could be to promote empiric treatment for syphilis at the point of care, the issue is that serology might not detect a syphilis infection for upwards of four to 6 weeks after exposure. 2,3 This means that in some cases, there is no conclusive diagnosis of primary syphilis, resulting in a lack of contact tracing of sexual partners or appropriate clinical follow-up for these persons, per extant clinical guidelines. 4 This situation also affects surveillance data about syphilis, potentially resulting in underreporting of infectious syphilis cases.…”

Section: Introductionmentioning

confidence: 99%

Direct fluorescence antibody testing augments syphilis diagnosis, compared to serology alone

Orser

O’Byrne

2021

Int J STD AIDS

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In Ottawa, Canada, we initiated protocols to include non-serologic syphilis testing, as direct fluorescence antibody (DFA) for patients with syphilis symptoms. The purpose was to assess the ability of DFA to detect syphilis during acute infection and to determine if non-serologic testing could yield an increased number of syphilis diagnoses. We reviewed charts of patients of our local sexual health clinic for whom syphilis was suspected. A total of 69 clinical encounters were recorded for 67 unique patients, most of whom were male. The most common symptom was a painless genital lesion. Of the 67 patients, 29 were found to have a new syphilis diagnosis, among whom, 52% had positive syphilis serology and positive DFA, 34% had a positive syphilis serology and negative DFA, and 14% had negative syphilis serology and positive DFA. While DFA testing did not yield an abundance of new cases, it was useful to support findings from syphilis serology or confirm diagnosis where serology was negative. Where available, alternate non-serologic tests, such as nucleic acid amplification tests, should be considered above DFA due to its higher sensitivity for detecting syphilis in primary lesions; however, in clinical situations, when new syphilis infection is suspected, empiric treatment should not be delayed.

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Serological tests for syphilis

Cited by 11 publications

References 9 publications

Generalized Asymptomatic Nodulo-Ulcerative Lesions Without Systemic Symptoms in a Secondary Syphilis Patient Co-Infected with HIV

Generalized Asymptomatic Nodulo-Ulcerative Lesions Without Systemic Symptoms in a Secondary Syphilis Patient Co-Infected with HIV

Computational methods applied to syphilis: where are we, and where are we going?

Direct fluorescence antibody testing augments syphilis diagnosis, compared to serology alone

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