Biological false-positive tests comprise a high proportion of Venereal Disease Research Laboratory reactions in an analysis of 300,000 sera

2005 ◽  
Vol 16 (11) ◽  
pp. 722-726 ◽  
Author(s):  
Alexandra Geusau ◽  
Harald Kittler ◽  
Ulrike Hein ◽  
Edda Dangl-Erlach ◽  
Georg Stingl ◽  
...  
Keyword(s):  
Retrospective Study ◽  
False Positive ◽  
Research Laboratory ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Venereal Disease Research Laboratory ◽  
Transmitted Infection ◽  
Specific Test ◽  
Disease Research ◽  
Syphilis Screening

This retrospective study on syphilis screening at the sexually transmitted infection (STI) unit of a University Department emphasizes the necessity of a treponemal-specific test as the appropriate screening test. The Venereal Disease Research Laboratory (VDRL) test for syphilis screening may, under certain circumstances, yield positive results in patients not infected with Treponema pallidum, a phenomenon referred to as biological false-positive (BFP) VDRL test. The aim of this study was to determine the frequency of BFP tests in a large sample of sera. In this retrospective study, we analysed the results of parallel VDRL and T. pallidum haemagglutination (TPHA) testing of a total of 514,940 blood samples obtained from patients at the Vienna General Hospital between January 1988 and November 1999. Patients' sera with incomplete data on stage and sex and duplicate sera were excluded, leaving 300,000 sera for analysis. The seroprevalence for syphilis was 1.77% ( n = 5320), as determined by a positive TPHA test. It was significantly higher in male than in female patients (2.03% versus 1.58%, P<0.001). Of the patients reactive in the TPHA test, 3257 (61.2%) were negative in the VDRL. With regard to reactivity in VDRL testing, 2799 patients (0.92%) of the study population were positive, of whom 736 (26%) were biological false positive. BFP reactivity was found in 0.24% of all patients and was significantly higher in women than in men (0.27% versus 0.20%, P<0.001) and in patients over 60 years of age (0.34%) as compared with those under 60 (0.25%, P<0.001). This proportion might be even higher, as reactivity in the VDRL at 1:0 and 1:2 dilutions without a positive treponemal test was not reported. The subgroup of HIV-positive patients ( n = 1415) revealed a 10-fold higher rate of BFP tests (2.1% versus 0.24), an effect being statistically significant. In a low syphilis prevalence population, BFP reactions comprise a high proportion of all VDRL reactors. Therefore, the use of the VDRL as a screening procedure is challenged.

Syphilitic chorioretinitis presenting as a choroidal granuloma

2020 ◽  
Vol 13 (4) ◽  
pp. e234022
Author(s):  
Avantika Dogra ◽  
Mudit Tyagi ◽  
Hrishikesh Kaza ◽  
Avinash Pathengay
Keyword(s):  
Case Report ◽  
Complete Resolution ◽  
Research Laboratory ◽  
Rare Case ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Venereal Disease Research Laboratory ◽  
Hemagglutination Assay ◽  
Disease Research ◽  
Choroidal Granuloma

A rare case of syphilitic uveitis presenting as a choroidal granuloma is described in this case report. The clinical picture resembled that of a tubercular choroidal granuloma. However, the patient was positive for treponemal (treponema pallidum hemagglutination assay) as well as non-treponemal tests (venereal disease research laboratory test) for syphilis. Therefore, the patient was treated for ocular syphilis and responded to antisyphilitic therapy. There was a complete resolution of the lesion at the end of 14 days of treatment.

Further support from an Irish psychiatric hospital for lack of value of routine serological tests for syphilis

1989 ◽  
Vol 6 (2) ◽  
pp. 142-143 ◽  
Author(s):  
Therese O'Neill ◽  
Brian McCaffrey
Keyword(s):  
Research Laboratory ◽  
Psychiatric Illness ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Venereal Disease Research Laboratory ◽  
Serological Tests ◽  
Infected Blood ◽  
Disease Research ◽  
Previous Infection ◽  
Antibody Tests

AbstractSince the establishment of St. Brendan's Hospital in 1815 many changes have been seen in the pattern of psychiatric illness but none as dramatic as that of neurosyphilis. When Professor John Dunne first worked there in 1922, 20% of the patients suffered from general paralysis of the insane (G.P.I.) for which there was no cure. Around this time Wagner Von Jauregg – a Viennese physician, observed that patients who had suffered malaria during war did not suffer from G.P.I. He introduced malarial therapy successfully for which he received the Nobel Prize in 1927. Professor Dunne introduced this therapy into St. Brendan's after visiting Wagner Von Jauregg in Vienna. Unfortunately the mosquitos used would not bite! He resorted to injecting malarial infected blood. Only benign tertian malaria was effective and it is believed that the high temperatures induced – 40-41°C killed the spirochaete. This was followed by quinine treatment for malaria. The treatment was very successful but superceded in latter years by penicillin. The incidence of syphilis fell dramatically from 1942-1977, although recently it has been reported that it is rising in females and heterosexual males.One hundred consecutive samples routinely tested for syphilis (using the Venereal Disease Research Laboratory (VDRL) and Treponema Pallidum Haemagglutination (TPHA) test), between January and April 1988 were examined. Ninety-eight were negative for VDRL and TPHA. Two patients, both male, revealed evidence of previous infection i.e. VDRL neg, TPHA positive with Fluorescent Treponema Antibody tests (FTABS) reactive and FTA IGM negative in both cases. Neither of the two patients had any signs or symptoms suggestive of neurosyphilis.

scholarly journals Prevalência de resultados positivos de VDRL (Venereal Disease Research Laboratory) e análise das variáveis epidemiológicas em pacientes atendidos no serviço de saúde pública.

HU Revista ◽  
2019 ◽  
Vol 43 (4) ◽  
pp. 383-390
Author(s):  
Aline Augusta Sampaio Fernandes ◽  
Ana Luísa Almeida Regina ◽  
Ana Cláudia Chagas de Paula Ladvocat ◽  
João Carlos Marques Félix ◽  
Joelma de Souza Coimbra Ishii ◽  
...  
Keyword(s):  
Research Laboratory ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Venereal Disease Research Laboratory ◽  
Disease Research

A sífilis é uma infecção causada pelo Treponema pallidum de transmissão sexual, sanguínea e vertical. Apesar de ser de fácil diagnóstico e tratamento, sua incidência vem aumentando no Brasil nos últimos anos, sendo considerado um problema de saúde pública no país e no mundo. Este trabalho buscou a conhecer a ocorrência de resultados positivos de VDRL (Venereal Disease Research Laboratory) entre o período de 2014 a 2016 na população atendida nos serviços de saúde da prefeitura de Juiz de Fora/MG, bem como suas características epidemiológicas. Foram analisados 25.735 resultados de VDRL do banco de dados do Laboratório Central (LACEN) da prefeitura de Juiz de Fora. Os resultados reagentes foram então relacionados com as variáveis ano, gênero, idade, gestantes ou não e região da cidade em que se realizou o exame. A prevalência de resultados positivos foi de 5,55%, com maior número de casos registrados em 2015. Os casos reagentes foram mais prevalentes na região central, nos homens e obteve-se maior predomínio para a faixa etária de 12 a 18 anos. No período de agosto de 2015 a dezembro de 2016, entre as mulheres, foi observada uma maior positividade no teste de VDRL em não gestantes. Os dados obtidos nesse estudo apontaram para aumento da prevalência de sífilis entre 2014 e 2015, seguido de uma queda no ano seguinte, entre a população atendida pelo SUS, sendo os homens jovens a população de maior risco. Tais dados podem contribuir para as políticas de saúde pública de prevenção e tratamento da sífilis.

Sifilis Pada Kehamilan

2020 ◽  
Vol 3 (1) ◽  
pp. 73-83
Author(s):  
Hari Darmawan ◽  
Izazi Hari Purwoko ◽  
Mutia Devi
Keyword(s):  
Research Laboratory ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Venereal Disease Research Laboratory ◽  
Rapid Plasma Reagin ◽  
Hemagglutination Assay ◽  
Disease Research

Sifilis adalah penyakit infeksi menular seksual disebabkan bakteri Treponema pallidumdapat ditularkan melalui hubungan seksual, transfusi darah, dan vertikal dari ibu ke janin.  Jika perempuan hamil menderita sifilis dapat terjadi infeksi transplasenta ke janin sehingga menyebabkan keguguran, lahir prematur, berat badan lahir rendah, lahir mati, atau sifilis kongenital. Diagnosis sifilis pada kehamilan ditegakkan berdasaranamnesis,manifestasi klinis, pemeriksaanlaboratorik, danserologik. Skrining pada trimester pertama dengan tes non-treponema seperti rapid plasma reagin(RPR) atau venereal disease research laboratory(VDRL) kombinasi dengan tes treponema seperti treponema pallidum hemagglutination assay(TPHA) merupakan hal penting pada setiap perempuan hamil. Manifestasi klinis sifilis ke janin bergantung pada usia kehamilan dan stadium sifilis maternal serta respons imun janin. Deteksi dini dan terapi adekuat penting untuk mencegah transmisi infeksi sifilis dari ibu ke janin.

scholarly journals False positive venereal disease research laboratory of cerebrospinal fluid

2015 ◽  
Vol 48 (2) ◽  
pp. S130 ◽  
Author(s):  
Yu-Jung Tung ◽  
Min-ham Hsieh ◽  
Chun-Yu Lin ◽  
Yen-Hsu Chen ◽  
Chung-Hao Huang
Keyword(s):  
Cerebrospinal Fluid ◽  
False Positive ◽  
Research Laboratory ◽  
Venereal Disease ◽  
Venereal Disease Research Laboratory ◽  
Disease Research

scholarly journals 339. Assessing Utilization of the Venereal Disease Research Laboratory Test in Cerebrospinal Fluid for the Diagnosis of Neurosyphilis: A Cohort Study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S239-S240
Author(s):  
Terin Sytsma ◽  
Elitza Theel ◽  
Zelalem Temesgan ◽  
Michel Toledano
Keyword(s):  
Cerebrospinal Fluid ◽  
Cohort Study ◽  
Clinical Practice ◽  
False Positive ◽  
Research Laboratory ◽  
Venereal Disease ◽  
Venereal Disease Research Laboratory ◽  
Inappropriate Use ◽  
Disease Research ◽  
False Positivity

Abstract Background The Venereal Disease Research Laboratory (VDRL) test performed in cerebrospinal fluid (CSF) is considered highly specific for the diagnosis of neurosyphilis, but algorithms to diagnose neurosyphilis require positive syphilis serologic testing prior to obtaining CSF-VDRL. Inappropriate use of diagnostic tests depletes healthcare resources, and contributes to rising healthcare expenditures. CSF-VDRL has historically been improperly utilized; however there is no recent evaluation of its use in clinical practice. We aimed to quantify rates of appropriate CSF-VDRL testing, determine the CSF-VDRL false-positivity rate and describe causes of false-positive CSF-VDRL reactivity. Methods In this retrospective cohort study of three Mayo Clinic sites (Rochester, MN, Jacksonville, FL, and Scottsdale, AZ), we measured the rate of appropriate CSF-VDRL test utilization in patients with negative testing from January 1, 2011 to December 31, 2017. We then identified all patients with positive CSF-VDRL testing from January 1, 1994 to February 28, 2018, characterized true- and false-positive rates and described causes of CSF-VDRL false-positivity. Results Among 8,553 persons with negative CSF-VDRL results, testing was unnecessarily ordered in 8,399 (98.2%). The word “syphilis” or “neurosyphilis” appeared in the notes of only 1,184 (13.8%) individuals with a negative CSF-VDRL result. From January 1994 through February 2018, 33,933 CSF-VDRL tests were performed on 32,626 individual patients. Among 60 positive CSF-VDRL results, 41 (68.3%) were true-positives, 2 (3.3%) were indeterminate, and 17 (28.3%) were false-positives. Every patient with true-positive CSF-VDRL had positive serologic syphilis testing prior to CSF testing. All patients with false-positive CSF-VDRL results were inappropriately tested. Neoplastic meningitis was a common cause of false-positive CSF-VDRL results. Conclusion This is the first study in decades to review CSF-VDRL utilization for the diagnosis of neurosyphilis. Inappropriate use of CSF-VDRL testing for diagnosis of neurosyphilis remains problematic in clinical practice. Following recommended testing algorithms would prevent unnecessary testing, preserve resources, and minimize false-positive results. Disclosures All Authors: No reported disclosures

scholarly journals Neurosifilis Asimtomatik Pada Pasien Sifilis Sekunder Dengan Koinfeksi Human Immunodeficiency Virus

2019 ◽  
Vol 8 (1) ◽  
pp. 1
Author(s):  
Dia Febrina ◽  
Dartri Cahyawari ◽  
Nina Roslina ◽  
Rasmia Rowawi ◽  
Pati Aji Achdiat
Keyword(s):  
Human Immunodeficiency Virus ◽  
Research Laboratory ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Venereal Disease Research Laboratory ◽  
Rapid Plasma Reagin ◽  
Disease Research ◽  
Immunodeficiency Virus

Neurosifilis merupakan infeksi pada sistem saraf pusat yang disebabkan invasi sawar darah otak oleh Treponema pallidum yang umumnya terjadi pada pasien sifiis koinfeksi dengan human immunodeficiency virus (HIV). Neurosifilis umumnya terjadi pada sifilis tersier, tetapi dapat pula terjadi pada stadium lainnya, termasuk stadium sekunder. Diagnosis neurosifilis asimtomatik ditegakkan apabila didapatkan serum venereal disease research laboratory (VDRL) yang positif tanpa tanda dan gejala neurologis disertai satu dari karakteristik berikut pada pemeriksaan liquor cerebrospinal (LCS): (1) jumlah leukosit > 10/mm3; (2) protein total > 50 mg/dL; (3) hasil VDRL reaktif. Dilaporkan seorang pasien laki-laki berusia 35 tahun dengan sifilis sekunder koinfeksi HIV tanpa ditemukannya tanda dan gejala neurologis. Kecurigaan neurosifilis pada pasien ini disebabkan oleh kegagalan terapi pada sifilis sekunder, status HIV dengan jumlah CD4+ 106/mm3, dan serum VDRL 1:256. Diagnosis neurosifilis pada laporan kasus ini ditegakkan berdasarkan pemeriksaan LCS yang menunjukkan hasil VDRL yang reaktif, peningkatan jumlah leukosit dan protein total. Pasien ini diberikan penisilin G prokain 2,4 juta unit tanpa probenesid yang diberikan secara intramuskular selama 14 hari. Pada pasien sifilis koinfeksi HIV dapat dicurigai neurosifilis apabila ditemukan salah satu karakteristik berikut: (1) tidak terjadi penurunan titer VDRL setelah terapi benzatin penisilin; (2) serum VDRL/rapid plasma reagin (RPR) ? 1:32; (3) jumlah CD4+ < 350 sel/mm3. Kegagalan terapi pada sifilis sekunder dapat disebabkan oleh infeksi Treponema pallidum pada sistem saraf pusat. Simpulan, dilaporkan satu pasien usia 35 tahun dengan neurosifilis asimtomatik yang diberikan terapi penisilin G prokain 2,4 juta unit tanpa probenesid selama 14 hari. Pemeriksaan serum VDRL pada bulan ketiga pasca terapi belum mengalami penurunan titer.

Sign in / Sign up

Export Citation Format

Share Document