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Syphilis Antibody
Aka: Syphilis Antibody, Syphilis Serology, Syphilis Screening, Syphilis False Positive, Syphilis Testing, Syphilis Diagnosis, Treponema test, Non-Treponemal Test- See Also
- Syphilis
- Neurosyphilis
- Syphilis Antibody (Syphilis Serology)
- Dark-field Microscopy
- Sexually Transmitted Disease
- Indication
- Syphilis (Treponema pallidum) detection
- Syphilis Screening at least annually for all Men who have Sex with Men and others at high risk of Syphilis
- Skin lesions or other clinical findings suggestive of Syphilis
- Confirmation of positive Screening Test
- Genital Ulcer
- Background
- Labs: Tests for detection of Treponemal Pallidum Antibody
- Non-Treponemal Derived Substance precipitates Antibody (False Negatives in first 4 weeks)
- Venereal Disease Research Laboratory (VDRL)
- Rapid Plasma Reagin (RPR)
- Automated Reagin Test (ART)
- Standard Test for Syphilis (STS)
- Treponemal Antigen precipitates Antibody (False Negatives in the first 2 weeks)
- Fluorescent Treponemal Antibody (FTA-ABS)
- Test Sensitivity: 80%
- Microhemagglutination - Treponema pallidum (MHA-TP)
- Test Sensitivity: 65% to 70%
- Fluorescent Treponemal Antibody (FTA-ABS)
- Non-Treponemal Derived Substance precipitates Antibody (False Negatives in first 4 weeks)
- Labs: Non-Antibody Tests
- Protocol: Testing
- Screening
- Nontreponemal tests (RPR or VDRL)
- HIV Screening (test all patients who are positive for Syphilis)
- HIV coinfection with Syphilis is common
- HIV patients are at higher risk of Neurosyphilis
- Negative test with lesions present or other strong clinical indicators
- Repeat screening in 2-3 weeks
- Confirmation of positive Screening Test
- Fluorescent Treponemal Antibody (FTA-ABS)
- Microhemagglutination - Treponema pallidum (MHA-TP)
- Neurosyphilis CSF Evaluation
- See Neurosyphilis
- Indications for Lumbar Puncture with CSF Exam
- Monitoring response to treatment
- Screening
- Interpretation: False Positives with the Non-Treponemal Tests
- Systemic Lupus Erythematosus
- Malaria
- Measles
- Endocarditis
- Infectious Mononucleosis
- Infectious Hepatitis
- Leprosy
- Lymphoma
- Brucellosis
- Atypical Pneumonia
- Miliary Tuberculosis
- Typhus
- Cohorts
- Pregnancy
- Advanced age
- Intravenous Drug Abuse
- Post-Vaccination state
- Related Treponemal infection
- Yaws
- Pinta
- Bejel
- Interpretation: False Positives with Treponemal tests
- Other Spirochete infections (Leptospirosis, Lyme Disease, rat bite fever)
- Efficacy
- Diagnostic Test Sensitivity in Primary Syphilis
- Dark-field Exam of Chancre: 80%
- Non-Treponemal Tests (e.g. RPR): 78-86%
- Treponemal tests (e.g. FTA-ABS): 76-84%
- Diagnostic Test Sensitivity in Secondary Syphilis
- Dark-field Exam of Chancre: 80%
- Non-Treponemal Tests (e.g. RPR): 100%
- Treponemal tests (e.g. FTA-ABS): 100%
- Diagnostic Test Sensitivity in Latent Syphilis
- Diagnostic Test Sensitivity in Tertiary Syphilis
- Diagnostic Test Sensitivity in Primary Syphilis
- Resources
- Diagnostic Tests for Syphilis
- Reference
- Mason and von Reinhart (2018) EM:Rap 18(6): 19-20
- Bakerman (1984) ABCs of Interpretive Lab Data, p. 392
- Larsen (1995) Clin Microbiol Rev 8:1-21 [PubMed]