12 Mar
2009

Serological tests provide indirect evidence of infection and are useful in the diagnosis of some STDs, notably syphilis, HIV infection and hepatitis B. The non-specific reagin tests are also useful in the follow up of treament of early syphilis. The role of serology in the diagnosis of other STDs is limited. Seroconversion or a four-fold increase in litre of chlamydial antibodies in paired serum samples may retrospectively confirm chlamydial infection. A high titre of IgG antibody and the presence of IgM antibody probably indicates recent active infection and negative serology may exclude chlamydial infection

Serological tests have no role in the diagnosis of HSV infection. The only possible role for serology is to define persons who are seronegative and therefore susceptible.

The various causes of genital ulceration including herpes, syphilis, donovanosis, chancroid, lymphogranuloma venereum, cutaneous amoebiasis and neoplasms may be distinguished by appropriate tests. Scrapings from ulcers after removal of the crust, exudate and debris can be examined directly and by culture on specific media leading to presumptive or definitive diagnosis. In some conditions, particularly if the diagnosis of malignancy must be excluded, biopsy is appropriate. Serology is important in the diagnosis of syphilis.

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