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Chapter 11.4 : Laboratory Diagnosis of Syphilis

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Laboratory Diagnosis of Syphilis, Page 1 of 2

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Citation: Leber A. 2016. Laboratory Diagnosis of Syphilis, p 11.4.1.1-11.4.8.3. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch11.4
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Figures

Image of Figure 11.4.1–1
Figure 11.4.1–1

Diagram to provide insight into the immunology and clinical manifestations of syphilis. (a) Primary and secondary stages can overlap, with secondary lesions appearing before primary lesions are healed ( ). (b) Reinfection can occur after treatment during any stage of infection ( ). (c) Neurosyphilis can occur during any stage of infection ( ). (d) Nontreponemal antibodies rise and peak at about 6 months and remain elevated if untreated ( ). (e) With adequate treatment, nontreponemal antibodies decline and may become undetectable in about a year ( ). (f) Treponemal IgM antibody titers rise early infections, peak at about 6 months, and gradually decline regardless of treatment, and they are usually undetectable after about a year ( ). (g) Treponemal IgG antibodies usually persist for life regardless of treatment ( ). (h) Nontreponemal assays become reactive at about 6 weeks postinfection but may not be detectable in early primary syphilis ( ). (i) Nontreponemal assays become reactive at about 6 weeks postinfection but may not be detectable in late latent syphilis ( ). (j) Treponemal tests detect antibodies about 3 weeks postinfection ( ). (k) Direct detection assays are useful when lesions are present in early syphilis ( ).

Citation: Leber A. 2016. Laboratory Diagnosis of Syphilis, p 11.4.1.1-11.4.8.3. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch11.4
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Image of Figure 11.4.1–2
Figure 11.4.1–2

Traditional testing algorithm for serologic diagnosis of syphilis. Abbreviations: RPR, rapid plasma reagin; TP-PA, particle agglutination. * if incubating or primary syphilis is suspected, treat with benzathine penicillin G at 2.4 million units intramuscularly in a single dose. †, evaluate clinically, determine whether treated for syphilis in the past, assess risk for infection, and administer therapy according to the CDC’s ( ) if not previously treated. §, if at risk for syphilis, repeat RPR in several weeks.

Citation: Leber A. 2016. Laboratory Diagnosis of Syphilis, p 11.4.1.1-11.4.8.3. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch11.4
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Image of Figure 11.4.1–3
Figure 11.4.1–3

Reverse-sequence testing algorithm for serologic diagnosis of syphilis ( ). Abbreviations: CIA, chemiluminescence immunoassay; RPR, rapid plasma reagin; TP-PA, particle agglutination. * if incubating or primary syphilis is suspected, treat with benzathine penicillin G 2.4 million units intramuscularly in a single dose. †, evaluate clinically, determine whether treated for syphilis in the past, assess risk for infection, and administer therapy according to the CDC’s ( ) if not previously treated. §, if at risk for syphilis, repeat RPR in several weeks.

Citation: Leber A. 2016. Laboratory Diagnosis of Syphilis, p 11.4.1.1-11.4.8.3. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch11.4
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References

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2. Pope V, Fears MB, Morrill WE, Castro A, Kikkert SE. 2000. Comparison of the Serodia Treponema pallidum particle agglutination, Captia Syphilis-G, and SpiroTek Reagin II tests with standard test techniques for diagnosis of syphilis. J Clin Microbiol 38:25432545.
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1. Ebel A, Vanneste L, Cardinaels M, Sablon E, Samson I, De Bosschere K, Hulstaert F, Zrein M. 2000. Validation of the INNO-LIA syphilis kit as a confirmatory assay for Treponema pallidum antibodies. J Clin Microbiol 38:215219.
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1. Larsen SA, Steiner BM, Rudolph AH. 1995. Laboratory diagnosis and interpretation of tests for syphilis. Clin Microbiol Rev 8:121.
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8. Larsen S, Johnson R, Pope V, Kennedy E. 1998. A Manual of Tests for Syphilis, 9th ed. Association of Public Health Laboratories, Washington, DC.

Tables

Generic image for table
Table 11.4.1–1

List of suppliers for syphilis diagnostic tests available in the United Slates

Citation: Leber A. 2016. Laboratory Diagnosis of Syphilis, p 11.4.1.1-11.4.8.3. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch11.4
Generic image for table
Table 11.4.3–1

Reporting quantitative results

Citation: Leber A. 2016. Laboratory Diagnosis of Syphilis, p 11.4.1.1-11.4.8.3. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch11.4
Generic image for table
Table 11.4.4–1

Criteria for determining degree of agglutination

Citation: Leber A. 2016. Laboratory Diagnosis of Syphilis, p 11.4.1.1-11.4.8.3. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch11.4
Generic image for table
Untitled

Citation: Leber A. 2016. Laboratory Diagnosis of Syphilis, p 11.4.1.1-11.4.8.3. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch11.4

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