日本性感染症学会誌 Journal of Japanese Society for Sexually Transmitted Infections

In this study, we discuss the diagnostic skills necessary for the diagnosis of syphilis and provide treatment at an earlier stage by considering the behavior of recent syphilis patients and the diagnosis process. Twenty-five syphilis cases were diagnosed (16 primary cases, 6 secondary cases, and 3 cases of asymptomatic syphilis) after excluding 12 cases from among the potential 37 cases. PCR testing was performed for 23 patients, and 17 (73.9%) tested positive. In particular, among primary syphilis patients, we could diagnose patients whose diagnoses would not have been possible using conventional techniques, such as those involving a small ulcer at a very early stage, those with crusted ulcerated lesions, and those who were not identified as syphilis positive with serological testing. However, we could not obtain definitive results for syphilis diagnosis using PCR for secondary cases with syphilitic lesions and initial sclerosis hidden by normal skin. Therefore, in order to increase the use of PCR, it is necessary to standardize these techniques and application methods. Moreover, with regard to the automation of testing using syphilitic antibodies, TPLA is demonstrated to become available faster than rapid plasma reagin and is believed to be useful for the early diagnosis of syphilis.