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Prozone phenomenon in secondary syphilis.

Ruchi Sidana¹, H C Mangala, S B Murugesh

¹Department of Dermatology, J. J. M. Medical College, Davangere, Karnataka, India.

Indian Journal of Sexually Transmitted Diseases and AIDS

|July 30, 2011

Summary

The prozone phenomenon can cause false-negative syphilis tests due to high antibody titers. This case highlights the importance of repeat testing at higher dilutions for accurate diagnosis, especially with rising Acquired Immune Deficiency Syndrome prevalence.

Keywords:

Acquired immune deficiency syndrome flocculation test prozone phenomenon syphilis

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Area of Science:

Immunology
Infectious Diseases
Dermatology

Background:

The prozone phenomenon, a high antibody titer interfering with antigen-antibody lattice formation, can lead to false-negative serological tests.
Syphilis diagnosis often relies on serological tests like the Venereal Disease Research Laboratory (VDRL) test.

Observation:

A patient with secondary syphilis presented with symptoms mimicking contact irritant dermatitis.
Initial VDRL testing was non-reactive, but became reactive upon repeat testing with higher dilutions.

Findings:

This case demonstrates a prozone phenomenon in a patient with secondary syphilis, leading to an initial false-negative VDRL result.
The prozone effect was overcome by serial dilution of the patient's serum.

Implications:

Increased prevalence of Acquired Immune Deficiency Syndrome (AIDS) is associated with a higher incidence of the prozone phenomenon.
Clinicians must be aware of the prozone phenomenon to ensure accurate syphilis diagnosis and appropriate treatment.
Serial dilution of serum is a crucial step in confirming VDRL results when prozone phenomenon is suspected.