Serologic Testing for Syphilis

Diagnosis: Contemporary Algorithm

April 2011

In this approach, serum samples are first tested by a treponemal-specific screening test, such as one based on enzyme immunoassay, or EIA, technology. Negative results by the screening EIA are interpreted as no serologic evidence of syphilis, and no further testing is required unless early syphilis is suspected. If, however, the treponemal screening test is positive, the sample should be tested by a nontreponemal test to assess the patient’s disease and treatment status. A positive result by the nontreponemal test generally is suggestive of syphilis, which is either untreated or recently treated. In contrast, a negative result by the nontreponemal test can yield several different interpretations based on the patient’s clinical and treatment history. We’ll go over these scenarios in more detail in just a few minutes.

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Diagnosis: Contemporary Algorithm

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Jump to section:

• Introduction
• Presentation Outline
• Syphilis — The "Great Imitator"
• Diagnosis: Laboratory Testing
• Diagnosis: Nontreponemal Serology Tests
• Diagnosis: Treponemal Serology Tests
• Diagnosis: Traditional Algorithm
• Diagnosis: Traditional Algorithm
• Syphilis — Incidence
• Syphilis — Incidence
• Diagnosis: Contemporary Algorithm
• Diagnosis: Contemporary Algorithm
• Diagnosis: Proposed Algorithm with Treponemal Screening Test
• Interpretation and Follow-up
• Interpretation and Follow-up
• Interpretation and Follow-up
• Interpretation and Follow-up
• Interpretation and Follow-up
• Conclusions
• Conclusions
• Questions?