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Diagnosis of syphilis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Diagnostic procedures include:

  • dark ground microscopy - detection of spirochaete in primary and secondary syphilis

  • serology - detection of anti-treponemal antibodies with:
    • non-specific antigen - cardiolipin used in the Venereal Disease Reference Laboratory (VDRL) test. This is not specific for Treponemes but is useful to assess the efficacy of treatment of proven syphilis - it will revert to negative once Treponema eliminated
    • specific treponemal antigens:
      • TPHA } remain positive life-long and
      • FTA-ABS } specific to Treponema pallidum

  • lumbar puncture may be indicated to exclude neurosyphilis

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