Information from references 2 and 9. Primary syphilis is treated with 2. In nonpregnant patients who are allergic to penicillin, alternative regimens include doxycycline Vibramycinin a dosage of mg taken orally twice daily for two weeks, or tetracycline, in a dosage of mg taken orally four times daily for two weeks. Limited evidence indicates that ceftriaxone Rocephinin a dosage of 1 g delivered intramuscularly or intravenously once daily for eight to 10 days, or azithromycin Zithromaxin a single 2-g dose taken orally, may be effective for the treatment of primary syphilis, although close follow-up is warranted to assess treatment efficacy.
Telephonefaxe-mail ac. All rights reserved This article has been cited by other articles in PMC. Abstract Syphilis has several clinical manifestations, making laboratory testing a very important aspect of diagnosis.
In North America, many unsuspected cases are discovered by laboratory testing.
The etiological agent, Treponema pallidum, cannot be cultured, and there is no single optimal alternative test. Serological testing is the most frequently used approach in the laboratory diagnosis of syphilis. The present paper discusses the various serological and alternative tests currently available along with their limitations, and relates their results to the likely corresponding clinical stage of the disease.
The need to use multiple tests is discussed, and the importance of quality control is noted. The complexity of syphilis serology means that the services of reference laboratories and clinical experts are often needed.
Canada, Laboratory diagnosis, Nontreponemal tests, Serology, Syphilis, Treponema pallidum, Treponemal tests The etiological agent of syphilis is Treponema pallidum.
Syphilis has diverse clinical manifestations and shares many clinical features with other treponemal and nontreponemal diseases. Syphilis progresses through distinct primary, secondary, latent and tertiary stages.
The ulcers that appear in primary and secondary syphilis are rich in treponemes; venereal transmission occurs through direct contact with these lesions. The stage of the disease at which the patient presents has implications for diagnosis and treatment.
In some stages, the disease may be asymptomatic, and there are problems in diagnosing very early syphilis, neurosyphilis, asymptomatic congenital syphilis and syphilis in intravenous drug users and persons coinfected with serologically cross-reacting agents and HIV.
Although T pallidum cannot be grown in culture, there are many tests for the direct and indirect diagnosis of syphilis. Still, there is no single optimal test. Direct diagnostic methods include the detection of T pallidum by microscopic examination of fluid or smears from lesions, histological examination of tissues or nucleic acid amplification methods such as polymerase chain reaction PCR.
Indirect diagnosis is based on serological tests for the detection of antibodies. Serological tests fall into two categories: All nontreponemal tests measure both immunoglobulin Ig G and IgM antiphospholipid antibodies formed by the host in response to lipoidal material released by damaged host cells early in infection and lipid from the cell surfaces of the treponeme itself.
All treponemal tests use T pallidum or its components as the antigen. If lesion exudate or tissue is available, direct examination is performed, followed by a nontreponemal serology test. A reactive nontreponemal test is then confirmed by a treponemal test.
A confirmed serological test result is indicative of the presence of treponemal antibodies but does not indicate the stage of disease and, depending on the test, may not differentiate between past and current infection.
Despite their shortcomings and the complexity of interpretation, serological tests are the mainstay in the diagnosis and follow-up of syphilis. Latent syphilis can only be diagnosed by serological tests.
In fact, in North America, the majority of syphilis cases are identified at the latent stage by serological tests. There are no reliable routine laboratory methods to distinguish the other pathogenic treponemes from each other or from syphilis.
Detailed descriptions of commonly used diagnostic procedures for syphilis can be found in current editions of laboratory manuals 12.What is syphilis? Syphilis is a sexually transmitted infection that can cause serious health problems if it is not treated.
Syphilis is divided into stages (primary, secondary, latent, and tertiary). There are different signs and symptoms associated with each stage.
The pathophysiology, natural history, clinical manifestations, and treatment of this disorder, as well as the laboratory monitoring of patients undergoing therapy, are discussed elsewhere. Serologic testing is generally used to make a diagnosis of syphilis.
The approach to testing is described below. Syphilis is a sexually transmitted disease with varied and often subtle clinical manifestations. Primary syphilis typically presents as a solitary, painless chancre, whereas secondary syphilis can.
The diagnosis of syphilis may involve dark-field microscopy of skin lesions but most often requires screening with a nontreponemal test and confirmation with .
Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, and tertiary).
The primary stage classically presents with a single chancre (a firm, painless, non-itchy skin ulceration) but there may be multiple sores. Syphilis, a sexually transmitted infection, first appears as painless sores on your genitals, rectum or mouth.
Early diagnosis is important. This content does not have an English version.