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*False-positive nontreponemal test results can be associated with various medical conditions unrelated to syphilis, including autoimmune conditions, older age, and injection-drug use;<ref name="pmid7548285">{{cite journal |author=Nandwani R, Evans DT |title=Are you sure it's syphilis? A review of false positive serology |journal=[[International Journal of STD & AIDS]] |volume=6 |issue=4 |pages=241–8 |year=1995 |pmid=7548285 |doi= |url= |accessdate=2012-02-16}}</ref> <ref name="urlwww.aphl.org">{{cite web |url=http://www.aphl.org/aphlprograms/infectious/std/Documents/LaboratoryGuidelinesTreponemapallidumMeetingReport.pdf |title=www.aphl.org |format= |work= |accessdate=2012-12-19}}</ref> therefore, persons with a reactive nontreponemal test should receive a treponemal test to confirm the diagnosis of 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;<ref name="pmid7548285">{{cite journal |author=Nandwani R, Evans DT |title=Are you sure it's syphilis? A review of false positive serology |journal=[[International Journal of STD & AIDS]] |volume=6 |issue=4 |pages=241–8 |year=1995 |pmid=7548285 |doi= |url= |accessdate=2012-02-16}}</ref> <ref name="urlwww.aphl.org">{{cite web |url=http://www.aphl.org/aphlprograms/infectious/std/Documents/LaboratoryGuidelinesTreponemapallidumMeetingReport.pdf |title=www.aphl.org |format= |work= |accessdate=2012-12-19}}</ref> 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.
===Nontreponemal test===
*Includes VDRL and RPR tests
*Antibody titers may correlate with disease activity  
*May reverse following treatment
*Used to follow treatment response
*A fourfold change in titer is necessary to demonstrate significant difference between two nontreponemal tests
*Results from two tests cannot be compared directly with eachother


*Trepenomal test antibody titres once positive remains positive for the rest of life regardless of treatment or disease activity.
===Trepenomal tests ===
*Include
*Antibody titres once positive remains positive for the rest of life regardless of treatment or disease activity
*cannot be used for monitoring treatment response
*Screening using trepenomal tests may help identify individuals previously treated for syphilis, those with untreated or incompletely treated syphilis, and persons with false-positive results


==References==
==References==

Revision as of 14:51, 28 September 2016

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

  • Includes VDRL and RPR tests
  • Antibody titers may correlate with disease activity
  • May reverse following treatment
  • Used to follow treatment response
  • A fourfold change in titer is necessary to demonstrate significant difference between two nontreponemal tests
  • Results from two tests cannot be compared directly with eachother

Trepenomal tests

  • Include
  • Antibody titres once positive remains positive for the rest of life regardless of treatment or disease activity
  • cannot be used for monitoring treatment response
  • Screening using trepenomal tests may help identify individuals previously treated for syphilis, those with untreated or incompletely treated syphilis, and persons with false-positive results

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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