Molecular testing for Treponema is used for rapid and accurate laboratory documentation of syphilis.
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Syphilis is a systemic, infectious disease caused by the spirochaete (spiral-shaped bacterium), Treponema pallidum. The microorganism is transmitted mainly through direct sexual intercourse and also through the placenta from mother to fetus. If syphilis is left untreated, infected people may develop irreversible complications such as chronic inflammation of the joints, cardiovascular problems such as valvular diseases, and problems with the central nervous system such as mental illness and paralysis.
Laboratory diagnosis of syphilis can be made by direct and indirect tests. Direct tests include scraping off syphilis lesions and determining the causative organism. Indirect tests detect antibodies against Treponema. These antibodies do not appear in the serum until 3 to 4 weeks after the appearance of an ulcer located at the point where the microorganism first enters the body.
Serological testing for syphilis includes VDRL (Venereal Disease Research Laboratory), RPR (Rapid Plasma Reagin), TPHA (Treponema pallidum Haemagglutination Assay), and FTA-ABS (Fluorescent Treponemal Antibody-Absorbed Test) tests as well as the test of IgM antibodies by immuno-enzymatic techniques (EIA). The VDRL and RPR are screening tests. Both of these tests have high rates of false-positive results. Conditions that can cause false-positive results include vaccination in children, antinuclear antibodies, blood loss (multiple transfusions), brucellosis, chancroid, chickenpox, cirrhosis, common cold, diabetes mellitus, fever, hypergammaglobulinemia, leprosy, leptospirosis (Weil's disease), Lyme disease, lymphogranuloma venereum, lymphoma, infection (chronic), malaria, measles, infectious mononucleosis, mycoplasma pneumonia, non-syphilis treponematosis diseases (bejel, pinta, yaws), periarteritis nodosa, pneumococcal pneumonia, pregnancy, rheumatic fever, rheumatoid arthritis, scarlet fever, scleroderma, aging, subacute bacterial endocarditis, systemic lupus erythematosus, tuberculosis (pulmonary advanced), trypanosomiasis, typhoid fever, vaccinia.
Due to the high rate of false positive results, any positive VDRL or RPR test should be followed by confirmatory testing, such as TPHA and FTA-ABS. These tests determine the specific antibodies against Treponema pallidum. The FTA-ABS test is the most sensitive test used to diagnose syphilis. This test will remain positive for life, even if the patient receives appropriate treatment.
Important Note
Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. The correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings, and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.
At Diagnostiki Athinon we answer any questions you may have about the test you perform in our laboratory and we contact your doctor to get the best possible medical care.
