Test Code: Syph Preferred Name Syphilis antibody

1 hour
1 day
Medicare Item

Test Tubes

ImageSpecimen TypeSpecimen VolumeTube Type
Blood (adult)8 mLSST with gel 8.5 mL (Dark Yellow Top)
Blood (paediatric/*neonatal (see collection note))1 mL2x SST with gel 600 uL Paed (Red or Yellow top)
CSF0.5-1.0 mLBlack top tubes (kit contains 3 tubes; sterile)


1. Syphilis Serology - Serum (EIA/RPR/TPPA)
Serum is the preferred specimen but plasma samples (lithium heparin or EDTA) can be used.

2. *Neonatal Syphilis Serology - for assessment of neonates for congenital Syphilis where maternal
serology is known to be reactive; request RPR and Syphilis IgM on neonatal sample.
Blood sample requirements - see under paediatric / neonatal above. Preferred volume is 1ml of blood;
minimum 600 ul.

3. Neurosyphilis - CSF (VDRL) (Test code: VDRLX)
Only VDRL is validated as a serolgical test for Syphilis on CSF. Both VDRL and MSC should be requested to exclude neurosyphilis.



1. An EIA Screening Test is performed and if positive a TPPA (Treponema pallidum particle agglutination) and RPR (Rapid Plasma Reagin) are performed.

2. The Syphilis EIA and TPPA detect specific Treponema pallidum antibodies and become positive within 1-4 weeks of exposure and remain positive for life.

3. The RPR detects non-specific antibodies related to the tissue damage the infection causes and appears later than the EIA/TPPA antibodies.  The RPR titre will decrease or revert to non-reactive with both time and treatment and is a measure of activity. An RPR titre of >16 is suggestive of active disease.

4. If the EIA screen is the only test positive, serum is sent to a reference laboratory for an FTA-ABs (Fluorescent treponemal antibody-absorbed) test to determine if the EIA is a false positive reaction or not.

5. If neurosyphilis is suspected, a lumbar puncture is indicated and the diagnosis made on the basis of a raised CSF cell count and protein and the presence of a positive VDRL (Venereal Diseases Research Laboratory) test.

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