Analyses on a syphilis

Analyses on a syphilis

Diagnostics of a syphilis is complex and includes bacterioscopic, serological studies and analysis of cerebrospinal liquid.

Bacterioscopic diagnostics of syphilis

Analyses to syphilis by the bacterioscopic method (microscopic) are carried out with the aid of the detection of pale treponemy in the dark-field microscope.

Diagnostics of syphilis of primary period is carried out by the experiment of the discharge of primary syphiloma (solid chancre), puncture specimen of regional lymphatic it is main. In diagnostics of syphilis of second period the material of papular, pustulous elements, erosive and hypertrophic papules of the skin and the mucous membranes is investigated. With the analyses to syphillis innate is used amniotic liquid, struck internal organs.

Serological diagnostics of syphilis

Netreponemnaya diagnostics of syphillis (netreponemnye tests): the reaction of the binding of complement with the kardiolipinovym antigen; microreaction with the plasma and the inactivated serum; RPR - test - the development of antibodies to the cardiolipin-lecithin- cholesterol antigen. This analysis to syphillis is the first stage - elimination, it makes it possible to trace the effectiveness of antisyphyllitic therapy. Netreponemnaya diagnostics of syphillis is highly sensitive with the early forms of syphillis.

Treponemnaya diagnostics of syphillis

Treponemnoy diagnostics of syphillis includes the reaction of the binding of complement (Wasserman reaction ). This method of the analyses of syphillis makes it possible to diagnose syphillis at its different stages.

Wasserman reaction is evaluated qualitatively and quantitatively: ++++ - is sharply positive, +++ - is positive, ++ - it is slightly positive, + - it is doubtful, - it is negative. Wasserman reaction is positive in 100% of sick with syphilis second period, with early innate syphillis, in 70%-80% of patients with tertiary syphilis.

The treponemnym method of diagnostics of syphillis is also the reaction of immunofluorescence (RIF). RIF is the most highly sensitive method of diagnostics of syphillis and becomes positive already with primary seronegative syphilis. RIF is the irreplaceable method of diagnostics of concealed syphillis, late syphilis. RIF it is positive with second syphilis, innate syphillis in 100%, with tertiary syphilis - in 95%-100%, with the late forms of syphilis (internal organs, syphillis of nervous system) - in 97%-100%. The reaction of immunofluorescence has different modifications: RIF -200, RIF - ABC.

The reaction of the immobilization of pale treponem ( IPT ) is the most specific serological test. Beginning from the second stage of syphillis IPT it is positive in all patients. IPT is the expensive and labor-consuming in the setting method of diagnostics of syphilis, the only to establishments with the high(ly)-specific laboratory equipment.

The specific method of diagnostics of syphilis is the reaction of passive hemagglutination (RPH) - the test, based on the determination of specific antibodies to pale treponeme. Setting this method of diagnostics of syphillis is possible only in the laboratories of the specialized medical agencies. Immunoenzyme analysis (IA) is one of the contemporary serological tests of analyses to syphillis and is used for formulating the diagnosis of both flowing and tracking of the passed syphilitic infection.

In diagnostics of syphilis cerebrospinal liquid with the suspicion of defeat by syphilis of nervous system is investigated;

• with syphilitic alopecia (second syphilis);
• to syphilitic leykoderme (second syphilis);
• with concealed late syphillis;
• in children from the mothers, sick with syphilis;
• as the criterion of izlechennosti of syphilis.

In the analyses to syphilis with a study of cerebro-spinal fluid are used the reactions of Wasserman, RIF, IPT. In the cerebro-spinal fluid it is investigated cytosis (quantity of cells), quantity of protein, specific globulin reactions of Pandy, Nonne-Apelt.