Which syphilis screening tests should be performed in the evaluation of suspected meningitis?

Updated: Jul 16, 2019
  • Author: Rodrigo Hasbun, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Perform serologic tests to detect syphilis. Screening for syphilis is done with the nontreponemal tests: rapid plasma reagent (RPR) or Venereal Disease Research Laboratory (VDRL). Positive results are confirmed with one of the following specific treponemal tests:

  • Fluorescent treponemal antibody absorption (FTA-Abs)

  • T pallidum hemagglutination (TPHA)

  • Microhemagglutination– T pallidum (MHA-TP)

  • The newer immune-capture enzyme immunoassay (ICE Syphilis) recombinant antigen test

In patients with syphilis, initial results on nontreponemal tests can serve as a baseline for gauging the success of therapy. Titers decrease and usually revert to negative or undetectable levels following effective treatment.


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