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

TEST: 012005
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CPT: 86592
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Synonyms

  • Nontreponemal Test
  • Serological Tests for Syphilis (STS)
  • Syphilis Serology

Test Includes

RPR, qualitative; RPR titer; and Treponema pallidum-specific test on reactives. An additional fee is charged when a confirmatory Treponema pallidum test is performed.

Expected Turnaround Time

1 - 2 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Documents

For more information, please view the literature below.

Improved Syphilis Reverse Screening Cascade: Earlier Detection With Fewer Ambiguous Results

Specimen Requirements

Specimen

Serum

Volume

2 mL

Minimum Volume

1 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Maintain specimen at room temperature.

Stability Requirements

TemperaturePeriod
Room temperature14 days
Refrigerated14 days
Frozen14 days
Freeze/thaw cyclesStable x3

Causes for Rejection

Hemolysis; lipemia; gross bacterial contamination; plasma specimen

Test Details

Use

This test is intended to support screening and diagnosis of syphilis infections. This test aligns with the CDC-supported traditional serologic testing algorithm for syphilis using a combination of both treponemal and nontreponemal antibody tests. The traditional syphilis testing algorithm begins with the RPR (nontreponemal) test with positive samples reflexing to RPR titer and treponemal antibody testing. Interpretation of results obtained must take into account patient symptoms and clinical history.

Limitations

Biological false positive results (RPR-reactive, Treponemal antibody-negative) have been associated with infections other than syphilis, as well as recent immunization, autoimmune disorders, pregnancy and injection drug use.

Methodology

Charcoal flocculation and chemiluminescence immunoassay

Reference Interval

Nonreactive

Additional Information

RPRRPR titerTreponemal Ab (TPAb)Interpretation
NonreactiveNot performedNot performedNo laboratory evidence of syphilis. If recent exposure is suspected, submit a new sample for testing in 2-4 weeks.
Reactive1:1 or higherNonreactiveNontreponemal antibodies detected. Syphilis unlikely; biological false positive possible. Clinical evaluation should be performed to identify current signs and symptoms or past history of infection or treatment. If recent exposure is suspected, submit a new sample for testing in 2-4 weeks.
Reactive1:1 or higherReactiveTreponemal and nontreponemal 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 or treatment.

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