Transcript SEROLOGICAL TESTS FOR SYPHILIS

SYPHILIS
DIFINITATON
• SYPHILIS IS A CHRONIC INFLAMATORY INFECTIOUS
SEXUALLY TRANSMITTED DISEASE CAUSED BY
• TREPONEMA PELLIDUM- A SPIROCHETE
• TRANSMITTED MOSTLY BY SEXUAL CONTACT WITH
INFECTED LESIONS OR BODY FLUIDS AND LESS COMMENLY
THROUGH TRENSPLACENTLLY FROM MOTHER TO UNBORN
CHILD & THROUGH BLOOD TRANSFUSIONS RARELY
THROUGH ACCIDENTAL INOCULATION OR PUNCTURE WITH
CANTAMINATED INSTUMENTS.
• DISEASE HAS GREAT VARIABILTY IN IT’S CLINICAL
PRSEANTATION AND COURSE- MIMICING VERY MANY
DISEASES IN THE FIELD OF MEDICINE & SURGERY
• TREATED SUCSSESFULLY BY PENCILLINS UPTO
PRESUPTION
TREPONEMA PELLIDUM
SILVER STAIN
STAGES OF SYPHILIS
AQUIED SYPHILIS
REMISSION
CONTACT 1/3 INFECTED
| 9 TO 90 DAYS
PRIMARY
| 3 TO 12 WEEKS
SECONDARY
| 4 TO12 WEEKS
EARY LATENT
WITH IN 1 YEAR OF CONTACT
|
TERTIARY
LATE LATENT
LATE BENIGN-16%
MORE THEN 1 YEAR
CARDIOVASULAR -9.5%
NEUROSYPHILIS-6.5%
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CLINICAL PRESENTATION
• CHANCRE
SYPHILITIC CHANCER
MULTIPLE PRIMARY LESIONS
AT MALE ENITALIA
CHANCRE AT FEMALE
GENITALIA
MACULAR SYPHILIDS
PAPULOPUSTULAR SYPHILIDS
MUCOUS PATCHES
CONDYLOMATA LATA
PRINATAL SYPHILIS
BULLOUS LESIONS AT SOLES
IN
PRINATAL SYPHILIS
SEROLOGICAL TESTS FOR
SYPHILIS
1. SCREENING TEST
CARDIOLIPIN BASED NONTREPONEMAL TEST (REAGINIC TEST)FLOCULATION TEST -VDRL,RPR
ANTIGEN IS CARDIOLIPIN+CHOLESTROL+LACITHIN
ANTBODIES- IgM,IgG IN SERUM OF PATIENT
BECOME REACTIVE IN 4 TO 5 WEEKS OF INFECTION
REVERT TO NON REACTIVE WITH IN 4 TO 6 MONTS OF TRATMENT
BIOLOGICAL FALSE REACTIVE TEST
2. SPECIFIC TREPONEMAL TEST –
SPECIFIC BUT POSITIVE IN -3 WEEKS AFTER INFECTION & REMAIN +
EVEN AFTERTREATMNET
FTA-ABS MOST SENSITIVE & SPECIFIC TEST, 95-100%
MHA-TP
CAPTIA (IgM)EIA USEFUL IN DIAGNOSIS OF REINFECTION , CONGENITAL
SYHILIS, NEUROSYPHILIS IS + IN CSF
INTERPRETATION OF STS
• RPR
•
-
•
-
•
+
SYPHILIS
•
+
•
MHA-TP
-
INCUBATING
-
CAPTIA IgM
-
+VE
+
+
-
+
+
SYPHILIS
+
-
•
+
-
•
POSITIVE
>
+
+
>
NO SYPHILIS OR
EARLY PRIMARY SYPHILIS
PRIMARY/SECONDARY
EARLY INFECTION
LATE SECONDARY/LATENT
BIOLOGICAL FALSE POSITIVE
LATE INFECTION/ TREATED
CASE/BIOLOGICAL FALSEREINFECTION/RELAPSE