Syphilis: Treponemal Antibodies With Reflex to RPR and RPR Titer, Reverse Screening and Diagnosis Algorithm

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Nonreactive

Not done

Not done

Not done

No laboratory evidence of syphilis. If recent exposure is suspected, submit a new sample for testing in 2-4 weeks.

Reactive

Nonreactive

Not done

Nonreactive

Treponemal antibodies not confirmed. Inconclusive for syphilis; potentially early syphilis, possible false positive. If recent exposure is suspected, submit a new sample for testing in 2-4 weeks. If clinical suspicion is low no further evaluation is necessary.

Reactive

Nonreactive

Not done

Reactive

Treponemal antibodies detected. Consistent with past or current (potentially early) syphilis. Clinical evaluation should be performed to identify current signs and symptoms or past history of infection. If past history of treatment reported, no further management is needed unless symptomatic or recent exposure suspected. If no symptoms or past history of treatment, and if recent exposure is suspected, submit a new sample for testing in 2-4 weeks.

Reactive

Reactive

1:1 or greater

Not done

Treponemal and nontreponemal antibodies detected. Consistent with past or current syphilis. Clinical evaluation should be performed to identify current signs and symptoms or past history of infection.