Diagnostic procedures include: (1)
Dark ground microscopy - detection of spirochete in primary and secondary syphilis
Serology. Serology testing requires the use of both treponemal (specific) and non-treponemal (non-specific) tests with the usual approach being a treponemal test as the initial serological test, followed by a non-treponemal test if the treponemal test is positive.
Treponemal tests include:
The Treponema pallidum particle agglutination (TPPA) assay was withdrawn from the UK in 2022 due to regulatory requirements.
Following a positive treponemal test, a non-treponemal test should always be undertaken to confirm the diagnosis, and to provide evidence of active disease or re-infection. Non-treponemal tests include:
Note (1)
Reference
1. Kingston M et al. BASHHUK. Guidelines for the management of syphilis 2024. International Journal of STD & AIDS 2024, Vol. 0(0) 1–19
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