ABSTRACT
BACKGROUND: With the increasing incidence of human immunodeficiency virus (HIV) infection and immunosuppressive therapy, the incidence of syphilis has been increasing. Given the fact that the above conditions may mask or obscure the usual clinical signs and symptoms of syphilis, a means of enhanced detection is essential. AIMS METHODS: The purpose of this study was to determine whether an immunoperoxidase method using an antibody against treponemes would increase the sensitivity and specificity of diagnosis in biopsies of patients with secondary syphilis. This was compared to serology and silver stain in cases of known syphilis. RESULTS: Immunoperoxidase for treponemes was at least as sensitive (9/10) as pathology (9/10), and more sensitive than conventional silver stain (6/10) or serology (7/10). CONCLUSIONS: In those equivocal cases of secondary syphilis, where confirmation is essential, immunoperoxidase for treponemes may be a useful adjunct.
Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Foot Dermatoses/diagnosis , Immunoenzyme Techniques/standards , Syphilis, Cutaneous/diagnosis , Treponema pallidum/isolation & purification , AIDS-Related Opportunistic Infections/pathology , Child , Foot Dermatoses/pathology , Humans , Male , Sensitivity and Specificity , Syphilis, Cutaneous/pathology , Treponema pallidum/enzymology , Treponema pallidum/immunologyABSTRACT
PURPOSE: To assess duplex Doppler ultrasound (US) in providing objective, reproducible measurements of blood flow in patients with reflex sympathetic dystrophy (RSD) who underwent surgical sympathectomy. MATERIALS AND METHODS: Findings in eight adult patients with RSD who were evaluated with arterial duplex Doppler US after surgical sympathetectomy were retrospectively reviewed. Pulsatility index (PI) and waveform characteristics were compared to clinical findings (temperature and sudomotor state) in sympathectomized limbs. RESULTS: Warm and dry limbs yielded a consistently low PI (usually less than 2) and biphasic waveform. Cold and clammy limbs, which indicated failed sympathectomy, produced a high PI (usually greater than 4) and triphasic waveform. The Doppler waveform promptly reverted with the return of sympathetic tone in patients who had clinical relapse. CONCLUSION: Duplex Doppler US may be useful for objective follow-up of RSD patients after sympathectomy.
