Serologic Testing for Syphilis

Diagnosis: Proposed Algorithm with Treponemal Screening Test

April 2011

This important question prompted members of the CDC and the Association of Public Health Laboratories to meet to discuss syphilis diagnostic testing, and subsequently propose that the following algorithm be followed when a treponemal-specific test is used for screening. In this algorithm, samples that are positive by a treponemal test but are negative by RPR should be tested by a second treponemal assay, such as the Treponema pallidum particle agglutination assay. The implementation of a second treponemal test will likely assist in the interpretation of results.

So at this point, you may still be asking yourself, “How do I interpret the results of syphilis serology and what follow-up action is required when I’m confronted with different patterns of results?”

To address these questions, let’s walk through several of the common scenarios and discuss which testing is recommended, and whether or not follow-up is required.

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Proposed Algorithm with Treponemal Screening

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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?