The authors first discuss the advantages and disadvantages of the various serological tests now in common use, or coming into use, for the detection and management of syphilis and also compare the different antigens used in those tests. They lay stress on the difficulties caused by the "unit" system of recording results, whereby identical findings with two or more tests may be given different numerical values for each test, and suggest that results should instead be given in dilution reactivity end-points (dils).False positive reactions to serological tests and discrepancies in the results of different tests are then considered; it is pointed out that these discrepancies may be due to causes in the patient himself, in transit, or in the testing laboratory.Finally, the authors consider that in view of the growing number of serological tests for syphilis, and of modifications to those tests, there is now a need for selecting, in different areas of the world, a certain number of procedures which can be standardized for routine testing. Regional serological evaluation studies can be used to this end. A brief outline is given of the United States Public Health Service programme to assist State laboratories to maintain a high level of efficiency in serological testing and thus to exert an influence on other laboratories within each State.

Humans↗

PubMed1956

The modern diagnosis of syphilis.

After briefly outlining the natural history of syphilitic infection, the authors review in detail the diagnosis of syphilis in the various stages of the disease and discuss the relative value at each stage of the commonly used serological tests and the Treponema pallidum immobilization (TPI) test. In their conclusions, they remark that the TPI test should be used with discretion and not as a matter of routine with all sera. Owing to its complexities and to the lengthy procedure involved, it is better suited for use with "problem" sera, for instance, sera from expectant mothers suspected of being acute non-treponemal reactors, or sera from persons with latent syphilis.

Humans↗

PubMed1956

Benzathine penicillin G in the treatment of syphilis.

Post-treatment observation of two years' duration has confirmed preliminary data which indicated that a single injection of 2.5 million units of benzathine penicillin G, in early infectious syphilis, produces results equal, if not superior, to those obtained with schedules employing 4.8 million units of procaine penicillin and aluminium monostearate.Preliminary data suggest that a single injection of 2.4 or 2.5 million units of benzathine penicillin G may be inadequate for the treatment of asymptomatic neurosyphilis.Delayed reactions do not appear to be induced by the long-sustained blood-levels following the administration of benzathine penicillin G.Repeated injections of PAM increase the risk of reaction to treatment.

Communicable Diseases↗

PubMed1955