Syphilis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

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Overview

Darkfield examinations and tests to detect T. pallidum in lesion exudate or tissue are the definitive methods for diagnosing early syphilis.

Laboratory Findings

  • Darkfield examinations and tests to detect T. pallidum in lesion exudate or tissue are the definitive methods for diagnosing early syphilis.
  • Although no T. pallidum detection tests are commercially available, some laboratories provide locally developed PCR tests for the detection of T. pallidum.
  • A presumptive diagnosis of syphilis is possible with the use of two types of serologic tests:
  • The use of only one type of serologic test is insufficient for diagnosis, because each type of test has limitations, including the possibility of false-positive test results in persons without syphilis.
  • False-positive nontreponemal test results can be associated with various medical conditions unrelated to syphilis, including autoimmune conditions, older age, and injection-drug use;[1] [2] therefore, persons with a reactive nontreponemal test should receive a treponemal test to confirm the diagnosis of syphilis.
  • Nontreponemal test antibody titers may correlate with disease activity and may reverse following treatment.
  • Trepenomal test antibody titres once positive remains positive for the rest of life regardless of treatment or disease activity.

References

  1. Nandwani R, Evans DT (1995). "Are you sure it's syphilis? A review of false positive serology". International Journal of STD & AIDS. 6 (4): 241–8. PMID 7548285. |access-date= requires |url= (help)
  2. "www.aphl.org" (PDF). Retrieved 2012-12-19.


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