Noel W. Preston
Department of Bacteriology and Virology, University Medical School, Manchester M13 9PT, England.
Garyounis Medical Journal Vol. 6, No.1. January 1983:79-84
There are two broad classes of diagnostic serological tests. In the first, an unknown antigen is identified by its specific reaction with one of several known antibodies and deductions are made about the identity of the microbe with which this antigen is associated. In the second, an unknown antibody in a patient’s serum is identified by specific reaction with one of several known antigens; the patient is deemed to have been infected with an organism known to cause the production of that antibody.
In both cases, there may be danger in assuming that an antigen is specific for just one kind of organism. Many examples of the fallacies in this assumption are discussed. It may be concluded that diagnosis bases on serology alone is often unreliable.
Far more confident laboratory diagnosis may be obtained by culture of the causative organism, where appropriate and possible. This allows the microscopic and cultural and biochemical properties of a bacterium to be utilised, as well as serology. But if infection is caused by a virus, there are more limited means of identification, and serology assumes a dominant role. The inherent problems in serological diagnosis cannot be removed. But more valuable information may be obtained from the results of serological tests if there is ready exchange of data and impressions between clinician and microbiologist.
Keywords: The Role of Serology in the Diagnosis of Infection