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In Brief

Serologic Testing

The first 300 words of the full text of this article appear below.

Syphilis. French P. BMJ. 2007;334 :143 –147[Free Full Text] Diagnostic Evaluation of Mononucleosis-like Illnesses. Hurt C, Tammaro D. Am J Med. 2007;120 :911.e1 –8 Notice to Readers: Caution Regarding Testing for Lyme Disease. MMWR Morbid Mortal Wkly Rep. 2005;54 :125 Newborn Screening for Congenital Infectious Diseases. Neto EC, Rubin R, Schulte J, Giugliani R. Emerg Infect Dis. 2004;10 :1069 –1073

Diagnosing infectious diseases involves the same skills as police and detectives use in their work. The investigator must identify the culprit, based on evidence at the scene, to bring the case to a successful close. Unfortunately, aficionados of mystery novels and television crime shows know that the sleuth rarely finds the criminal at the scene of the crime, with weapon in hand. Instead, solving the crime usually requires the tedious collection of specific evidence that links the suspect to the deed.

In medicine, we have the ability to culture many organisms, giving definitive proof of the presence of a pathogen at the time of an illness. However, this technique is not available for many microorganisms that cause human disease. Many bacteria, of several different categories, are difficult to culture in the microbiology laboratory. Among them are spirochetes, such as Borrelia burgdorferi (Lyme disease), B recurrentis (relapsing fever), Leptospira sp (leptospirosis), and Treponema pallidum (syphilis, pinta, yaws, bejel). Another group includes intracellular pathogens such as Brucella sp (brucellosis), Bartonella sp (cat-scratch disease), and Mycoplasma sp (walking pneumonia), as well as rickettsiae, which are obligate parasites and cause spotted fevers (Rocky Mountain spotted fever and rickettsial pox), typhus, and scrub typhus. Finally, some bacterial species are not isolated by routine techniques in the microbiology laboratory, such as Legionella sp (legionellosis), Francisella tularensis (tularemia), and Bordetella sp (pertussis, parapertussis).

Similarly, . . . [Full Text of this Article]

Paul J Lee, MD
Leonard R. Krilov, MD
Winthrop-University Hospital
Mineola, NY

Henry M. Adam, MD, Editor, In Brief

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