¿Sigue siendo útil la microscopia de campo oscuro en el diagnóstico de la sífilis primaria en el siglo XXI? / Is dark-field microscopy still useful for the primary syphilis diagnosis in the 21ST century?

IntroducciónLa serología luética en la sífilis primaria puede ser negativa los primeros 5-15 días. El objetivo de este trabajo fue evaluar los beneficios de incluir la microscopia de campo oscuro (MCO) en el algoritmo diagnóstico de la sífilis primaria.MetodologíaSe incluyó a todos los pacientes que acudieron a una clínica de infecciones de transmisión sexual de la Comunidad de Madrid entre 2015 y 2019 que presentaban una úlcera genital sospechosa de sífilis primaria. Se les realizó MCO y serología (EIA/TPPA/RPR).ResultadosDe las 806 muestras, el 53,2% (429) fueron positivas para MCO. De los 429, el 48% presentaba screening serológico negativo (EIA/RPR) y de ellos en el 77,6% el TPPA fue positivo.ConclusionesLa MCO permite un diagnóstico de sífilis primaria precoz, incluso sin confirmación serológica. Si no se dispone de técnicas directas, en primoinfección, la TPPA es de gran ayuda en el diagnóstico.

IntroductionSerological test for primary syphilis could be negative the first 5-15 days. The aim of this study was to evaluate the benefit of including dark field microscopy (DFM) in the diagnosis algorythm for primary syphilis.Materials/methodsPatients attended to a sexual transmission diseases clinic of Madrid, from 2015 to 2019, for a genital ulcer with clinical suspicion of primary syphilis. They were tested for DMF and serological test (EIA/TPPA/RPR).ResultsOver the total amount of samples (806), 53.2% (429) were positive for DFM. Thus, the 48% of the 429 patients had negative serological test (EIA/RPR) of which the 77.6% were positive at TPPA.ConclusionsDFM allows primary syphilis early diagnosis, even without serological test. If no direct detection methods are available, for patients without history of syphilis, TPPA could help to diagnose primary syphilis.

Is dark-field microscopy still useful for the primary syphilis diagnosis in the 21ST century?

INTRODUCTION: Serological test for primary syphilis could be negative the first 5-15 days. The aim of this study was to evaluate the benefit of including dark field microscopy (DFM) in the diagnosis algorythm for primary syphilis. MATERIALS/METHODS: Patients attended to a sexual transmission diseases clinic of Madrid, from 2015 to 2019, for a genital ulcer with clinical suspicion of primary syphilis. They were tested for DMF and serological test (EIA/TPPA/RPR). RESULTS: Over the total amount of samples (806), 53.2% (429) were positive for DFM. Thus, the 48% of the 429 patients had negative serological test (EIA/RPR) of which the 77.6% were positive at TPPA. CONCLUSIONS: DFM allows primary syphilis early diagnosis, even without serological test. If no direct detection methods are available, for patients without history of syphilis, TPPA could help to diagnose primary syphilis.

Is dark-field microscopy still useful for the primary syphilis diagnosis in the 21ST century? / ¿Sigue siendo útil la microscopia de campo oscuro en el diagnóstico de la sífilis primaria en el siglo XXI?

INTRODUCTION: Serological test for primary syphilis could be negative the first 5-15 days. The aim of this study was to evaluate the benefit of including dark field microscopy (DFM) in the diagnosis algorythm for primary syphilis. MATERIALS/METHODS: Patients attended to a sexual transmission diseases clinic of Madrid, from 2015 to 2019, for a genital ulcer with clinical suspicion of primary syphilis. They were tested for DMF and serological test (EIA/TPPA/RPR). RESULTS: Over the total amount of samples (806), 53.2% (429) were positive for DFM. Thus, the 48% of the 429 patients had negative serological test (EIA/RPR) of which the 77.6% were positive at TPPA. CONCLUSIONS: DFM allows primary syphilis early diagnosis, even without serological test. If no direct detection methods are available, for patients without history of syphilis, TPPA could help to diagnose primary syphilis.

Urocultivos negativos con utilización de microscopía de campo oscuro / Negative urine cultures using dark field microscopy

El trabajo se realiza en el Laboratorio de Microbiología del Centro Provincial de Higiene y Epidemiología (CPHEM) de Guantánamo, con el objetivo de instaurar la microscopía de campo oscuro para descartar urocultivos negativos. El universo de estudio está formado por 200 muestras de orina, las que concurrentemente se siembran en el medio de cultivo cistina lactosa electrolito deficiente (CLED) y se observan al microscopio de campo oscuro, para comparar los resultados. Se obtiene que en los urocultivos que no se observan bacterias, resultan negativosal cultivo y en los que se observan bacterias, leucocitos o hematíes, resultan positivos al cultivo. Se concluye que se pueden descartar urocultivos negativos, utilizando la microscopía de campo oscuro, evitando realizar siembra en CLED, manteniendo la calidad del diagnóstico. Con la aplicación de este trabajo se logra el ahorro de medios de cultivo, cristalería, tiempo de incubación (energía), así como un diagnóstico rápido de los negativos (AU)

The work is done at the Microbiology lab, Provincial Center of Hygiene and Epidemiology ( CPHEM) Guantanamo , with the aim of establishing dark field microscopy and negative urine culture . The universe consisted on 200 samples of urine, concurrently are seeded in culture medium cystine lactose electrolyte deficient ( CLED) and were observed in a the dark field microscope. Results, in the urine culture were not seen bacteria, leukocytes or erythrocytes, are negatives on the contrary with urine culture - positive . As a conclusion in negative urine culture can be ruled out using the dark field microscopy , avoid planting in CLED, maintaining the quality of diagnosis. With the application of this work it can be saved culture media, glassware, incubation time (energy) and a negative rapid diagnosis