3. Preparing for surgery;
With secondary fresh syphilis, a sharply positive result for all standard serological reactions is observed in almost 100% of cases; Reagin titer is the highest – 1: 160; 1: 240 or 1: 320. RIF – 4; RIBT gives a positive result in more than half of patients, however, the percentage of immobilization of treponemia is low (40-60%).
In the serology laboratory, the Wasserman reaction, the Lange reaction with colloidal gold, RIT, RIF, RIFC (immunofluorescence reaction with whole cerebrospinal fluid), as well as the TRNA reaction, or the FTAABS reaction, or the IgM TPHA reaction, are put in the serology laboratory. A negative TRNA or FTAABS reaction excludes neurosyphilis. A positive IgMTPHA reaction with cerebrospinal fluid and a TPNA index of over 10 confirm the presence of a syphilitic process in the central nervous system.
The use of RIF is also advisable for the diagnosis of syphilis. The test with whole cerebrospinal fluid (RIFc) is especially highly sensitive and specific. RIBT with cerebrospinal fluid according to the assessment of the results is similar to that in the study of blood serum. The use of RIF RIBT and IgM TRNA enhances the detection of syphilitic lesions of the nervous system.
These reactions are inherent in us by nature: the human body never ignores the invasion of microbes on its territory – antibodies are immediately produced in the blood.
(class G immunoglobulins) are late antibodies that are also responsible for general immunity. They are smaller and more specific (better prepared for the destruction of treponema) than I gM.
In our country, the ELISA procedure for the serodiagnosis of syphilis with domestic ingredients has been developed in the Department of Microbiology of the Central Research and Design Institute for Veterinary Medicine. The study of 1609 samples of blood serum and cerebrospinal fluid revealed a sensitivity of 95,2% and high specificity. Negative results of ELISA in fully treated patients with syphilis can serve as a criterion for cure (Dmitriev G.A.).
Treatment of patients with syphilis is carried out with specific drugs, which include treponemocidal antibiotics such as potassium and sodium salts of benzylpenicillin, bicillin-1, bicillin-3, bicillin-5 and reserve antibiotics – erythromycin, tetracycline, oletetrin, ericycline. Benzylpenicillin and its derivatives are currently the main means of treating patients with syphilis.
Benzylpenicillin is used in the form of a sodium (potassium and novocaine) salt. Derivatives of benzylpenicillin are durant drugs, i.e., drugs with a prolonged therapeutic effect. These include bi-cillin-1, bicillin-3 and bicillin-5. Early forms of syphilis respond better to penicillin treatment than latent and late ones.
Nevertheless, there are generally accepted norms, knowing which, you can focus on the results of the analyzes. However, once again it is important to pay attention that the final diagnosis or its refutation can be established exclusively by a qualified doctor who is familiar with the full medical history of the patient.
As antigens, factory-made preparations are used that are similar in structure to lipid antigens that appear in the body when tissues are destroyed by a pale spirochete, lipids of its membranes and specific molecular compounds that make up pale spirochete furniture (purified and ultra-sonic treponem strains or isolated from them recombinant antigens).
All serological tests are divided into treponemal and non-treponemal.
Try to repeat the examination in an independent laboratory yourself. It is necessary to undergo an examination by ELISA and RIF. During pregnancy, in some cases, the Wasserman reaction can be positive without syphilis. In the event that the tests are confirmed, you will need to undergo treatment according to the schedule prescribed by your doctor.
The method consists in a multiple increase (amplification) of the amount of DNA of a detected microorganism. The development of PCR variants for the diagnosis of syphilis is due to the lack of standard tests for early seronegative, congenital syphilis and neurosyphilis. PCR is an excellent method for diagnosing syphilis with a small amount of treponemas in the test material.
A great advantage of PCR is the ability to automate the reaction by a given cyclic temperature regime for a color reaction determined by labeled primers. The question remains unclear – does the presence of treponemal DNA reflect the presence of viable treponeme or can it be the remains of dead microorganisms containing capable of amplification of DNA.
ELISA can determine total antibodies to treponema pallidum total, as well as separately I gM. I gG and even I gA.
In the primary period
syphilis, when a solid chancre appears on the skin, immunity is only gaining strength, and blood tests for syphilis will be negative in the first weeks. This period is called early seronegative syphilis. When the test results become positive, the diagnosis is made: early seropositive syphilis.
In this case, the question arises about the seroresistance of syphilis. This condition occurs, as a rule, after an inferior treatment. This is manifested by persistent positive results of nontreponemal tests during the year and a more or delayed and insignificant decrease in antibody titer – less than 4 times in 1,5 years. In this case, additional treatment of syphilis is mandatory.
Since the beginning of the 60s, penicillin and its durant derivatives are the drugs of choice in the treatment of patients with syphilis. The most widespread among durant penicillins was the NN-dibenzylethylenediamine salt of benzylpenicillin, which is produced in many countries under various names – bicillin-1, retarpen, extensillin, tardocillin, pentiben.
High therapeutic efficacy, minimal treatment time (1-2 weeks), high economic indicators put benzathine-benzylpenicillin in one of the leading places among the known drugs for the regular treatment of syphilis patients. Foreign researchers, relying on pharmacokinetic data, refused to use multicomponent antibiotics, opting for benzathine-benzylpenicillin, a single injection of which at a dose of 2,4 million units provides treponemocide concentration of the antibiotic in the blood for 21-23 days.
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Chlamydia 1 80
Passive hemagglutination reaction (Treponema pallidum hemagglutination assay) is based on the definition of
erythrocyte agglutination, but the surfaces of which are characterized by antigens of pale treponema, which occurs only in the presence of antitreponemal antibodies. It was proposed by T. Rathlev in 1965 and is widely used for serodiagnosis of syphilis and refers to specific (treponemal) tests.
What happens to syphilis antibodies after cure
The appearance of tertiary syphilides (tubercles and gum) marks the beginning of the tertiary period, which occurs in 40% of untreated and inferiorly treated patients. The waves of the tertiary period are separated by longer (sometimes long-term) periods of latent infection. In the affected organs and tissues, destructive changes occur.
2. Preparation for pregnancy;
I gA – early syphilis, infection occurred recently (less than two weeks);
These antibodies “attack” microbes and, if they do not destroy the disease, then at least slow down its development.
Different forms of syphilis of the nervous system and visceral syphilis have different frequencies and expressiveness of standard seroreaction. So, progressive paralysis in 100% of cases is accompanied by sharply positive all standard serological reactions. Syphilis of cerebral vessels, spinal cord, syphilitic lesions of the cardiovascular system are accompanied by positive seroreactions in only 40-50-60% of cases. However, RIBT for almost all of the above pathological conditions gives a sharply positive result (90-100% immobilization).
Hello, I received the tests, ELISA anti-Louis was not detected, no RV was detected, RPGA (4), the venereologist recommends that you still be treated, penicillin 15 times a day at 20 weeks, and then 6 days after treatment. Your opinion on how I should lie down and be treated or try to consult with a doctor (other) And what do you think. thanks
1. Specific treatment of patients with syphilis with an established and confirmed diagnosis.
In order to avoid any negative consequences, it is better not to forget that chlamydia provokes quite serious health problems, and therefore even results such as 1 5 are best checked again. Ideally, such microorganisms should not be present in humans, however, these test indicators can be triggered by the presence of other genital infections treated previously.
After treatment, it is impossible to remove antibodies to syphilis from the blood. Over time, they will disappear themselves. Until this time, the patient needs to have an extract in his hands that the treatment has taken place and was successful.
In the primary period
. from 7-10 days of solid chancre, non-treponemal tests become positive, and from 3-4 weeks – treponemal tests.
Since chlamydia is a type of disease that often proceeds hidden and does not manifest specific symptoms, its detection in the later stages is by no means a rare phenomenon. So, the detected titer of 1 is evidence that the disease has been going on for a long time in the chronic phase and at the moment, in addition to the need to treat the patient for chlamydia, a whole series of measures will be required to eliminate the consequences of this disease. The detected titer of chlamydia 160 is also a reason to examine the sexual partner (or partners) with whom the patient had a recent relationship. It is impossible to ignore such indicators in any case, since a neglected infection of such a plan leads to numerous disorders of the urogenital sphere, including infertility.
Chlamydia titer 1 5
The use of PCR can be of great importance in the diagnosis of congenital syphilis (passive transplacental transfer of antibodies does not affect the test results), neurosyphilis, primary seronegative syphilis (currently the only criterion is the direct microscopic detection of treponemas), as well as in patients who are diagnosed with syphilis with using conventional serological reactions is difficult due to HIV infection (Dmitriev G.A. Bragina E.E.).
The chlamydia antibody score of 1 80 is interpreted depending on which class of antigens is identified as a result of the analyzes. If such a titer was shown by Ig G with negative Ig A, the patient has nothing to worry about, as this is evidence that the disease was transferred and antibodies to it remained in the blood.
7-8 ml (but not more than 10 ml) of cerebrospinal fluid are collected in a test tube. This amount is distributed in two test tubes, one of which is sent to a clinical laboratory, and the other to a serological laboratory.
For the first time, I gG appear 4-5 weeks after infection, and as their titer (concentration in the blood) increases, they become visible in routine analyzes 7-8 weeks after infection (i.e., 3-4 weeks after the appearance solid chancre).
In the classical course, the incubation period lasts 3-4 weeks, the primary seronegative – 1 month, then the primary seropositive – 1 month, then the secondary period – 2-4 years, then the tertiary period. In the primary period, a solid chancre occurs (a painless ulcer or erosion with a dense bottom at the site of penetration of pale treponema), accompanied by regional lymphangitis and lymphadenitis. At the end of the initial period, the chancre independently heals, and lymphadenitis passes into polyadenitis and lasts up to five months.
Polymerase chain reaction (PCR).
Can my negative Rh factor affect my tests? (My husband is positive. Perhaps I have a Rhesus conflict with the fetus (since there were 2 abortions before this pregnancy). And where can I go to understand this situation? And how will this treatment affect the fetus.
The first generalized rash is a sign of the beginning of the secondary period. Secondary syphilides appear undulating (for 1,5-2 months each wave) and disappear on their own. They can be represented by spotted, papular, pustular syphilis, syphilitic alopecia (baldness) and syphilitic leukoderma (the “necklace of Venus”). In the second half of secondary syphilis, polyadenitis disappears.
Research Preparation: Not required.
I gG – late syphilis (more than 2-4 years) or successfully treated syphilis.
A major advantage of nontreponemal tests over treponemal tests is the ability to quantify antibodies in the body (titer determination) and, accordingly, control the effectiveness of treatment.
Hello! I am 27 years old and 38 weeks pregnant. Analysis in the antenatal clinic showed RW, was sent to the police department to refine the analysis. She was tested there, the doctor didn’t show me the results, only reported that they were all positive (late latent, unspecified syphilis) and sent for an examination to the infectious diseases hospital.
A situation like yours is common. In order to understand whether there is a need for re-treatment of the disease, let’s look at what kind of analysis you have passed and what options for the development of the situation are currently available.
To successfully reduce the incidence of syphilis, the need for a set of measures has been established. Timely diagnosis with the identification of sources and contacts is combined with the active appointment of modern treatment in accordance with the characteristics of the patient’s body and the peculiarity of the symptoms of the process. The work carried out by many research institutes, departments of skin and venereal diseases of medical institutes, aimed at improving the treatment of syphilis, has been repeatedly discussed at congresses and international symposia of dermatovenerologists.
In a clinical laboratory, cytosis, protein content, and the Pandy and Nonne-Apelt globulin reactions are examined. Minimum pathological changes in the cerebrospinal fluid are as follows: protein content, starting from 0,4%, cytosis – 8 cells in 1 μl, globulin reactions (Nonne-Apelt reaction, Pan-di reaction; Lange reaction – more than two doubles in numerical value, positive Wasserman reaction).
The indicators above, even being isolated, indicate pronounced pathological changes in the cerebrospinal fluid. Pathological is also considered such cerebrospinal fluid in which several indicators are changed according to the data of minimal pathology, and the Wasserman reaction is positive.
A protein concentration in the cerebrospinal fluid of more than 400 mg/L and the number of cells in it more than 5000 per 1 L indicate an inflammatory process in the central nervous system. A system of four pluses is used to indicate the positivity of globulin reactions and RS; sharply positive result (4), positive – 3, weakly positive – 2 and doubtful – 1.
Modern advanced seroreactions using the principles of enzyme immunoassay constants.
Blood and organ donors for transplantation
These proteins are produced during the primary and secondary periods of syphilis, while in the tertiary period they gradually disappear. I gM say that the disease is in an active stage, and disappear after treatment. However, in some people, they can persist up to 1-1,5 years after cure.
With congenital syphilis in infants with active manifestations, standard seroreactions may be negative in 1% of cases.
if not, then there are no antibodies, and the person is considered healthy.
Types of RPGA
Since the reaction intensity varies during such an analysis, this served as the basis for using this method not only for diagnosis, but also for tracking the dynamics of the disease. Therefore, RPGAs are conventionally divided into two subspecies.
Any analysis that answers the question: is there a pathogen in the body or not, is called quality. Often this is enough to diagnose the disease and begin treatment.
Expert opinionArtem Sergeevich Rakov, venereologist, experience of more than 10 yearsAntibodies are not immediately developed. The causative agent (pale treponema) needs time to spread throughout the body and cause an immune response. Therefore, it is not worth taking an analysis the day after a likely infection, the result will be unreliable.
However, one should take into account the fact that antibodies to the causative agent of the disease remain in the body forever. And if a person is sick with syphilis, has undergone a course of treatment and has recovered, even decades later, antibodies will be found in his blood. How, then, to find out: has the infection again occurred or not? The answer to this question is given by the semiquantitative analysis of RPGA.
It is impossible to count the number of antibodies to pale spirochete. However, in order to approximately estimate their amount, titration of the test sample is carried out. Determining syphilis of rpg semiquantitatively means sequentially diluting the serum until the moment when the “adhering” red blood cells cease to be detected. Accordingly, if there are few of them, a small number of dilutions will be required, and if there are many, you will have to breed in a large amount of titrant.