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Syphilis
Published in Shiv Shanker Pareek, The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
These detect specific antibodies to T. pallidum and are used to confirm positive non-treponemal tests. Because of their specificity, a positive result may be obtained long after successful treatment for syphilis. Fluorescent treponemal antibody absorption (FTA-ABS) test.Treponema pallidum particle agglutination (TP-PA) assay.Treponema pallidum haemagglutination (TPHA) test.Enzyme immunoassay (EIA) test.
Genital ulcers and blisters
Published in Manu Shah, Ariyaratne de Silva, The Male Genitalia, 2018
Manu Shah, Ariyaratne de Silva
Preliminary screening tests: EIA/ IgG-testTPHA, MHA-TP or TPPA may be used (VDRL or RPR are also occasionally used in addition)FTA-abs test or EIA-IgM test may be the first test to be positive if primary syphilis is suspected.
How to master MCQs
Published in Chung Nen Chua, Li Wern Voon, Siddhartha Goel, Ophthalmology Fact Fixer, 2017
Optic atrophy is a physical sign and further tests are needed to find the underlying cause. Vitamin B12 deficiency is a cause of optic atrophy and a full blood count may show macrocytosis and hypersegmentation of the neutrophils. Serum folate may give the same haematological pictures but optic atrophy is not a feature of folate deficiency. Positive serum FTA Abs may suggest syphilis as a cause of the optic atrophy. Colour vision test and visual evoked potential are abnormal in optic atrophy and do not provide information about the underlying cause.
Utility of Treponemal Testing from Aqueous Fluid in the Diagnosis of Ocular Syphilis in Patients with HIV/AIDS
Published in Ocular Immunology and Inflammation, 2022
Nivedita Nair, Sridharan Sudharshan, Appakkudal R. Anand, Jyotirmay Biswas, K. Lily Therese
Ocular syphilis (OS) has varied manifestations and can mimic other ocular infectious diseases.1–3 Clinical diagnosis is often difficult. A diagnosis of ocular syphilis is made when a patient has ocular inflammation compatible with syphilis, with a positive syphilis serology and if all other possible infectious causes are excluded. Serological tests include both a treponemal test (TT) and nontreponemal test (NTT). The NTTs are those that detect antibodies to cardiolipin-lecithin-cholesterol antigen and TTs are those that detect antibodies against treponemal antigens. VDRL and RPR are the two most commonly used NTTs. The treponemal tests include the fluorescent treponemal antibody absorption test (FTA-ABS), hemagglutination treponemal test (HATE) for syphilis, Treponema pallidum hemagglutination assay (TPHA-TP) and the micro-hemagglutination (MHA) test.5 Among the various algorithms for syphilis diagnosis,7–9 the Centers for Disease Control (CDC) recommends the reverse algorithm. In this algorithm, a positive treponemal test, such as an enzyme immunoassay (EIA), TPHA or FTA-ABS which detects antibodies to treponemal antigens is done, as an initial screening test for syphilis. If any of these tests are positive, it needs to be followed by a non-treponemal test such as VDRL or RPR which detect antibodies directed against membrane phospholipids such as cardiolipin8,9. This CDC algorithm using serum samples is meant for diagnosis of syphilis in general and is not specific for ocular or neurosyphilis.
Alopecia syphilitica, from diagnosis to treatment
Published in Baylor University Medical Center Proceedings, 2022
Mojahed Mohammad K. Shalabi, Brooke Burgess, Samiya Khan, Eric Ehrsam, Amor Khachemoune
Methods currently used for diagnosis of AS include serological screening, immunohistochemistry, and polymerase chain reaction (PCR). Serological, nontreponemal tests such as Venereal Disease Research Laboratory (VDRL) and rapid plasma reagin (RPR) tests diagnose secondary syphilis at 100% sensitivity.10 When used to screen for syphilis, VDRL and RPR have a high sensitivity; however, false-positives are common due to the cross-reactivity with antigens associated with other conditions, such as infectious mononucleosis, rheumatoid arthritis, lupus, and leprosy. Because false-positives may occur with screening tests, the fluorescent treponemal antibody absorption (FTA-ABS) test serves as a specific, confirmatory test to rule out false-positives.11,12
Serologic false-positive reactions for syphilis in children of adenoidal hypertrophy:2 case reports and review of the literature
Published in Acta Clinica Belgica, 2021
Wei Wang, Xuzhou Fan, Xuelian Huang, Jingmei Yan, Jianfeng Luan
Serological tests for syphilis, which can be divided into treponemal and nontreponemal antibody tests, are used for the initial diagnosis of syphilis. The two most commonly used nontreponemal tests are the venereal disease research laboratory (VDRL) and the rapid plasma reagin (RPR), both of which are used to measure nonspecific antibodies against phospholipids [16].However, the nonspecific antibodies against phospholipids, including cardiolipin,can be produced under a variety of disease states, such as atypical pneumonia,brucellosis,chronic liver disease, rheumatic heart disease, subacute bacterial endocarditis and systemic lupus erythematosus, etc [17].These may lead to biological false-positive results.As the most widely used treponemal test, the fluorescent treponemal antibody absorption assay(FTA-ABS) measures specific antibodies formed by the host in response to infection with Treponema Pallidum.Its sensitivity is higher than that of the VDRL and the RPR.However,technical factors can cause false positives in the FTA-ABS due to the subjectivity and difficulty in reading fluorescence [18].