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Sex Transm Dis. 1996 Sep-Oct;23(5):366-9.

Comparison of methods for the detection of treponema pallidum in lesions of early syphilis.

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1
Department of Medicine, State University of New York Health Science Center, Brooklyn 11203, USA.

Abstract

BACKGROUND:

The clinical diagnosis of primary and secondary syphilis can be difficult because of the wide variability of lesions. The available laboratory tests (dark-field microscopy and direct fluorescent antibody) require specialized microscopes and skilled technicians, and serologic tests are insensitive in early infection.

METHODS:

Dark-field microscopy and monoclonal antibody staining were compared to a new solid-phase enzyme-linked immunosorbent assay (Visuwell test) for detection of T. pallidum in lesion exudate of 188 patients with genital lesions.

RESULTS:

Sixty-four patients (34%) had lesions of early syphilis diagnosed by either dark-field, monoclonal antibody staining, or both. The Visuwell test and dark-field examination were positive in 52 (81.3%) and 55 (85.9%) of the 64 patients, respectively, whereas the monoclonal antibody staining technique demonstrated the presence of T. pallidum in 59 (92.2%) of the 64 patients. The Visuwell test gave a negative result in 111 of 124 patients who had negative dark-field and direct fluorescent antibody test results (89.5% specificity).

CONCLUSIONS:

The Visuwell test is an alternative method for evaluating genital ulcers but is less sensitive and specific than existing tests.

[Indexed for MEDLINE]

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