Clinical analysis and laboratory evaluation on 51 cases of early syphilis

Objective: Analyze clinical manifestation of early syphilis and evaluate the laboratory techniques of diagnosis. Methods: 51 cases of early syphilis were summarized, RPR, FTA-ABS, Western blot and PCR techniques were compared in the diagnosis. Results: Primary syphilis, 6 of 51 cases (11.8%), often appear an atypical chancres or irregular ulcers at genital organ, which may be easily lost from early diagnosis in female patients. Most of the patients reported in this paper were grouped as secondary syphilis (74.5%), the clinical characteristic lesions of which, important for differential diagnosis, are multiform syphilides concentrated around genital area, dark red macules at palm and sole sites, and perianus condyloma flat. Several laboratory techniques were evaluated in the diagnosis of those patients. RPP as a screening method showed a low sensitivity (73.2%), FTA-ABS as a confirmation test is widely used at present, high quality of the antigen smear is the crucial point of a success experiment. Western blot and PCR techniques are highly sensitive methods but still under researching and developing, more clinical data should be accumulated to testify the efficiency of the techniques.Conclusion: secondary syphilis is the major clinical type at present; specific test to the antigen of treponema padium such as FTA-ABS is the first choice in the laboratory diagnosis of syphilis.