DARKFIELD EXAM, SYPHILIS
| Item | Value | ||||||||||||||||||
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| Approval req'd? | yes, Microbiology Laboratory Medicine Resident | ||||||||||||||||||
| Available Stat? | No | ||||||||||||||||||
| Test code | DFE | ||||||||||||||||||
| Performed by? | Microbiology (Bacteriology) | ||||||||||||||||||
| Sendout? | no | ||||||||||||||||||
| Price range | $$$ | ||||||||||||||||||
| In House Availability | AT SFGHMC, BY APPOINTMENT:
On weekdays, call and schedule with the Laboratory Medicine Resident in Microbiology, 206-5699 or pager (415) 443-1438.
On PMs, weekends and holidays, schedule with the Laboratory Medicine Resident on call, 206-8590 or pager (415) 443-6969. AT THE SAN FRANCISCO CITY CLINIC: (487-5500), 356 - 7th Street, drop-in service is provided during the following hours:
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| Principle | Motile treponemes may be present in a fresh lesion (chancre) of syphilis or a secondary syphilis skin lesion. Their characteristic motility and spiral shape can aid in the presumptive diagnosis of this infection before a serologic response can be detected. Darkfield microscopy is necessary because the organisms are not readily stained or visible in smears examined by conventional light microscopy. | ||||||||||||||||||
| Collection Instructions | At SFGHMC, specimens must be collected by the Microbiology Laboratory Medicine Resident. Fluid is collected from the base of an unhealed chancre that has been gently cleansed with anti-bacterial-free saline. Persistent compression of edematous base of chancre will cause upwelling of fluid. Secondary syphilis: Skin lesions are gently abraded with a #11 Bard-Parker blade with compression to collect fluid. |
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| Normal range | No Treponemes resembling T. pallidum seen | ||||||||||||||||||
| Synonyms | Syphilis or Treponema Pallidum Studies, Darkfield; | ||||||||||||||||||
| Stability | The specimen should be examined with a Darkfield Microscope within 15 minutes of collection | ||||||||||||||||||
| Additional information | Note: One dose of penicillin renders darkfield search for Treponema pallidum valueless because it stops motility and alters the appearance of T. pallidum (it "unwinds" the characteristic spiral form). | ||||||||||||||||||
| References | 1. Forbes BA, et al. Bailey and Scott's Diagnostic Microbiology, 11th Ed., Mosby, St. Louis MO, 2002. 2. Murray PR, et al. Manual of Clinical Microbiology, 9th Ed., ASM Press, Washington, DC, 2007. 3. Wentworth BB and Judson FN. Laboratory Methods for the Diagnosis of Sexually Transmitted Diseases, American Public Health Association, 1987. |
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| CPT coding | 87164 |
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| Last Updated | 6/17/2011 1:19:42 PM |