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Serologic Testing for Syphilis


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Diagnosis: Traditional Algorithm

Slide 7

April 2011

Now that we’ve reviewed the laboratory methods that can be used to assist in the diagnosis of syphilis, I wanted to spend a few minutes focusing on how serology is used and results interpreted. For decades, clinical laboratories have used a traditional algorithm for syphilis serology that is outlined on this slide. In this approach, serum samples are first tested using a non-treponemal screening test, such as RPR. If the result of the RPR is negative, the interpretation is that there is no serologic evidence of syphilis and no further testing is required. However, if the RPR is positive, it is recommended that a treponemal test, such as TP-PA or FTA be performed to confirm the results of the RPR. If the treponemal test is negative, the results would not be consistent with syphilis and the RPR would be considered a false-positive result. However, if the treponemal test is positive, this would be consistent with syphilis and treatment would be considered.

Diagnosis: Traditional Algorithm


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