Syphilis
Shiv Shanker Pareek in 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.
Posterior uveitis
Gwyn Samuel Williams, Mark Westcott, Carlos Pavesio, Bushra Thajudeen in Practical Uveitis, 2017
Syphilis blood testing can be confusing to the ophthalmologist. This should not be the case however as in reality it is really simple. If you tick ‘syphilis serology’ on the blood test form, then a modern lab in the developed world (Europe and North America) will do either the FTA (fluorescent treponemal antibody absorption test) or syphilis IgG. Never use the ‘VDRL test’ (which stands for venereal disease research laboratory) to test for syphilis and never write this on the form. This test along with the rapid plasma reagin (RPR) are older tests and are not even specific tests for syphilis. They work by detecting antibodies to cardiolipin-lecithin-cholesterol antigen. A number of other conditions falsely react with this – including systemic lupus erythematosus (SLE), Lyme disease and IV drug abuse. More worryingly, these tests can be falsely negative in late syphilis disease.
Bacterial Sexually Transmitted Diseases
Attila Lorincz in Nucleic Acid Testing for Human Disease, 2016
Morse et al.62 tested genital ulcer specimens by multiplex PCR from 105 consecutive patients seen at a genitourinary medicine clinic in Maseru, Lesotho. Nontreponemal (RPR) and treponemal (fluorescent treponemal antigen-antibody absorption test [FTA-ABS]) serologic test results were available from 98 patients. When serological test results were compared to those obtained by multiplex PCR, 6% (2 of 35) with negative serologic test results, 0% (0 of 1) with only a reactive RPR test result, 57% (13 of 23) with reactive RPR and FTA-ABS tests and 21% (8 of 39) with only reactive FTA-ABS tests had T. pallidum DNA detected by multiplex PCR. A positive multiplex PCR result was strongly associated (P = 0.003) with both reactive RPR and FTA-ABS tests in those with indeterminate diagnoses. Overall, FTA-ABS tests were reactive in 91% (21 of 23) of patients with positive multiplex PCR results for T. pallidum; in contrast, RPR tests were only reactive in 56.5% (13 of 23) of these 23 patients (P = 0.007). T. pallidum multiplex PCR results were negative in 67% (42 of 63) of patients with reactive RPR or FTA-ABS test results.
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
En-Face Optical Coherence Tomography of Acute Syphilitic Posterior Placoid Chorioretinopathy
Published in Ocular Immunology and Inflammation, 2018
Claudio Zett, Luiz H Lima, Silvana Vianello, Adriano Ferreira, Gabriel Costa de Andrade, Michel E Farah, Rubens Belfort
ASPPC is represented by a single or several yellowish and placoid lesions within the posterior pole or mid-periphery of the fundus that may coalesce and become large confluent lesions. Generally, such lesions have a colorless center and stippled RPE hyperpigmentation.8–10 In all the three patients, a characteristic ASPPC with a large, circular, and placoid lesion within the posterior pole was observed. The typical ASPPC angiographic findings of early hypofluorescence and late hyperfluorescent staining were also present in all the study cases.11,12 The diagnosis of syphilis is usually challenging due to the disease heterogeneity and difficulty of serological tests interpretation. It is recommended that the screening for syphilis should include both the FTA-ABS and the VDRL tests because FTA-ABS could lead to false-negative results and VDRL may give information regarding the disease activity.13 In our series, the FTA-ABS testing was positive in all the three reported cases and VDRL in three cases. Although some reports have suggested an association between the occurrence of ASPPC and HIV infection, none of our cases tested positive for HIV. Generally, the clinical features of ASPPC are very similar in both HIV-positive and HIV-negative patients.12,15,16
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].