Serologic Testing for Syphilis

Interpretation and Follow-up

April 2011

In the third scenario, a patient with no history, or an unknown history, of syphilis tests positive by the screening treponemal assay, but the reflex testing by RPR is reported as negative. In this situation, a second treponemal test is performed on the same serum sample and is reported as negative. These results would be consistent with a false-positive screening test, and no further testing is required unless clinically indicated. I should highlight that the second treponemal test should be a different method than the one used for screening, and the CDC has recently recommended that TP-PA be used to resolve discordant screening treponemal and RPR results.

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Interpretation and Follow-up

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• 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?