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Sexually transmitted infections

Syphilis Serologic Tests

Serologic Tests

Culture of T. pallidum is not available. The diagnosis of syphilis is based on serologic findings and/or darkfield microscopic examination of the organism or direct immunofluorescent microscopy. The later two procedures require special equipment and an experienced technician.

Two different types of antibodies are measured: the nonspecific nontreponemal reaginic antibody and the specific antitreponemal antibody. The nonspecific tests are inexpensive, rapid, and convenient for screening large numbers of sera and as an indication of disease activity. Specific antibody tests establish the high likelihood of a treponemal infection, either currently or at sometime in the past. The diagnosis is usually established by using the two types of serologic tests. Serologic tests may be negative in active cases, especially in older patients.