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Test Code: Syph Preferred Name Syphilis antibody

No
1 hour
Daily
1 day
Medicare Item
N/A

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)

COLLECTION NOTES

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.

GENERAL NOTES



SEROLOGICAL TESTS FOR SYPHILIS

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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