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      Laboratory diagnosis and interpretation of tests for syphilis.

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      Clinical Microbiology Reviews
      American Society for Microbiology

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          Abstract

          The lack of a method for demonstrating the presence of Treponema pallidum by growth necessitates the use of alternative methods. Traditionally, these methods are divided into direct detection methods (animal inoculation, dark-field microscopy, etc.) and serologic tests for the presence of patient antibody against T. pallidum. Serologic methods are further divided into two classes. One class, the nontreponemal tests, detects antibodies to lipoidal antigens present in either the host or T. pallidum; examples are the Venereal Disease Research Laboratory and rapid plasma reagin and tests. Reactivity in these tests generally indicates host tissue damage that may not be specific for syphilis. Because these tests are easy and inexpensive to perform, they are commonly used for screening, and with proper clinical signs they are suggestive of syphilis. The other class of test, the treponemal tests, uses specific treponemal antigens. Confirmation of infection requires a reactive treponemal test. Examples of the treponemal tests are the microhemagglutination assay for antibodies to T. pallidum and the fluorescent treponemal antibody absorption test. These tests are more expensive and complicated to perform than the nontreponemal tests. On the horizon are a number of direct antigen, enzyme-linked immunosorbent assay, and PCR techniques. Several of these techniques have shown promise in clinical trials for the diagnosis of congenital syphilis and neurosyphilis that are presently difficult to diagnose.

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          Author and article information

          Journal
          Clinical Microbiology Reviews
          Clin. Microbiol. Rev.
          American Society for Microbiology
          0893-8512
          1098-6618
          January 01 1995
          January 1995
          January 1995
          January 01 1995
          : 8
          : 1
          : 1-21
          Article
          10.1128/CMR.8.1.1
          a04fcd4e-7296-4b92-a858-635b438836b7
          © 1995
          History

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