Serological diagnosis of lymphogranuloma venereum.

Lymphogranuloma venereum (L.G.V.) has been known for many years under such names as lymphogranuloma inguinale, lymphopathia venereum, climatic bubo, poradenitis, or Nicolas and Favre's disease. Frei (1925) introduced a skin test, for long regarded as specific, using a treated suspension of pus from a bubo as antigen. With this he obtained in patients with lymphogranuloma venereum a papular reaction 1-1 cm. in diameter, 36-48 hours after intradermal inoculation. Control patients with other diseases showed no reaction. Using the same antigen he attempted without success to demonstrate complement-fixing antibody in sera from positive patients. During the next 15 years attempts were made, with equivocal results, to demonstrate complementfixing antibody in sera from patients suffering from L.G.N., using antigens prepared in this manner. Coutts and others (1934) obtained positive fixation in sera from three out of five cases using a 1 per cent. aqueous phenolized pus suspension as antigen. Later, with a 1 in 30 suspension, complement fixation occurred in eighteen out of twenty sera from patients diagnosed clinically as suffering from L.G.V. Melczer and Sipos (1937), reviewing previous results, concluded that antigens varied in their potency according to the amount of virus present. Attempts to overcome this difficulty by preparing antigens from infected mouse brain, or guinea-pig or rabbit lymph nodes were not successful.