Bhavsar Chintan, Patel Raksha M, Marfatia Yogesh
Department of Skin and VD Baroda Medical College SSG Hospital Vadodara, Gujarat, India.
Indian J Sex Transm Dis AIDS. 2014 Jan;35(1):35-9. doi: 10.4103/0253-7184.132426.
To validate syndromic management of cases having genital ulcerative disease (GUD) and urethral discharge syndrome (UDS).
A study of 113 cases of GUD and UDS was carried out in the Department of Skin and VD from March 2011 to August 2012. All cases having history and clinical evidence suggestive of GUD and UDS were included in the study.
According to syndromic diagnosis, GUD herpetic syndrome was the most common 71 (62.27%), followed by GUD non-herpetic syndrome 25 (21.89%) and UDS 17 (14.91%). Out of 71 cases clinically diagnosed as GUD herpetic, 16 (22.53%) were validated by immunoglobulin M (IgM) anti herpes simplex virus-2 (HSV) serology, 14 (19.71%) by Tzanck smear and 3 (4.22%) by both. 24 (33.80%) were Reactive plasma Reagin (RPR)(<1:8) reactive and trepenomma palidum haem-agglutination positive. Out of total 25 clinically diagnosed GUD non herpetic cases, 22 (88%) were validated by laboratory tests Out of 17 cases of UDS, 15 (88%) were validated by smear.
Sensitivity and specificity of clinically diagnosed syndrome is not so high particularly for GUD herpetic syndrome Continuous monitoring of diagnostic component of syndromic approach is key to success of STD control program.
验证对患有生殖器溃疡性疾病(GUD)和尿道分泌物综合征(UDS)病例的综合征管理方法。
2011年3月至2012年8月在皮肤与性病科对113例GUD和UDS病例进行了一项研究。所有有GUD和UDS病史及临床证据的病例均纳入研究。
根据综合征诊断,GUD疱疹综合征最为常见,有71例(62.27%),其次是GUD非疱疹综合征25例(21.89%)和UDS 17例(14.91%)。在71例临床诊断为GUD疱疹的病例中,16例(22.53%)通过抗单纯疱疹病毒2型(HSV)免疫球蛋白M(IgM)血清学得到验证,14例(19.71%)通过Tzanck涂片得到验证,3例(4.22%)通过两者均得到验证。24例(33.80%)梅毒反应素环状卡片试验(RPR)(<1:8)呈反应性且梅毒螺旋体血凝试验呈阳性。在总共25例临床诊断为GUD非疱疹的病例中,22例(88%)通过实验室检查得到验证。在17例UDS病例中,15例(88%)通过涂片得到验证。
临床诊断综合征的敏感性和特异性不是很高,尤其是对于GUD疱疹综合征。持续监测综合征方法的诊断组成部分是性传播疾病控制项目成功的关键。