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How to identify syphilis in the survey, methods of laboratory and Express diagnostics

Syphilis has many faces. Infection once in the body, leaves marks not only on the skin and genitals, but also destroys the nervous system, musculoskeletal system, lungs, impairs hearing and vision. Despite the wide range of symptoms and their combinations, doctors have learned how to identify disease and accurately indicate the stage of its development.

Who needs diagnosis

Society wants to protect you from being infected with pale Treponema. But because a number of rapid tests for early diagnosis of syphilis or identify carriers of the infection. The rule became blood sampling for laboratory diagnosis:

  • in cases of pregnancy;
  • before surgery;
  • donors before donating blood or organs for transplantation;
  • medical workers, teachers, workers of public catering, etc.;
  • from the military;
  • prisoners.

Laboratory test and clinical examination for syphilis will:

  • patients with signs of STD;
  • sexual partners and other family members of a person with an established diagnosis of "syphilis";
  • babies born to sick mothers;
  • anyone diagnosed with another sexually transmitted disease;
  • test the effectiveness of a therapeutic method in the treatment;
  • anyone screening gave a positive result.

The procedure of detecting infection at a reception at the venereologist

From a conversation with the patient, the doctor explains:

  • is there a confirmed diagnosis of "syphilis" in a partner;
  • were there any earlier rash on the genitals;
  • inflamed lymph nodes;
  • had there been any unprotected sex 3-4 weeks ago.

During clinical inspection of the skin, genitals, anus, mucous membranes specialist explains the similarity of the rashes and other skin lesions to those characteristic of syphilis. Thoroughly palpable peripheral lymph nodes to assess the degree of their increase.

Трепонема при темнопольной микроскопии

Antibodies to the Treponema actually reveal the methods:

  • ELISA – ELISA – ELISA (Enzymelynked immunosorbent assay);
  • FTA – reaction immunofluorescence REEF (Fluorescent treponemal antibody);
  • RW – reaction of binding complement (Wasserman);
  • RW treponemal antigen – Rst;
  • TPHA – reaction of passive hemagglutination – TPPA (Treponema pallidum haemagglutination assay);
  • TPI – reaction immobilization pale treponem – RIBT or RIT (Treponema pallidum immobilization test);
  • Western Blot – immunoblotting.

Venereologists follow a certain order of serological tests. As the Express-diagnostics is carried out one of the non-treponemal tests. Embrace the low sensitivity in early and late stagesinfection. Therefore, both negative and positive responses at a certain clinical picture should be verified treponemal methods.

In different situations can be observed combination of positive and negative responses. To decipher them will help table.

Non-treponemal (NTT) Treponemal (TT) Interpretation
- - Examined the patient is healthy and never suffered with syphilis
Primary syphilis in the first week of development
Primary syphilis patients in 6-12 months after treatment
In HIV-infected people in the stage of active syphilis in the phenomena Hass and Hick as a result of delayed seroconversion
- + In early form of overt syphilis after successful treatment
In patients with primary syphilis
In secondary syphilis, and the phenomenon of prozone
If late untreated syphilis
When biologically false positive TT
In patients with autoimmune diseases, in cancer and infectious disease patients pregnant
In the terminal stage of HIV infection
+ - When biologically false positive serological reactions
+ + In untreated patients with syphilis at any stage of infection
In patients with systemic lupus erythematosus and other diseases with abnormal or excessive production of antibodies

Final conclusions does the venereal diseases on the basis of the data set: clinical, histological and laboratory tests.


  1. Akoubian V. A., Prokhorenkov V. I., Novikov A. I., Guzey, T. N. // Syphilis: illustration hand-in (edited by V. I. prokhorenkov). – M.: Medkniga, 2002. – S. 194-201.
  2. Dmitriev G. A., Frigo N. In. // Syphilis. Differential clinical and laboratory diagnosis. – M: Honey. book 2004. – S. 26-45.
  3. Loseva O. K., Lowenergy A. N. Epidemiology, clinical features, diagnosis and treatment of syphilis: hands-on for doctors. – M., 2000.
  4. Pankratov V. G., Pankratov, O. V., Navrotsky, A. L. and others // the Recipe (the Appendix]. scientific.-pract. Conf. "Modern approaches to diagnostics, treatment and prevention of sexually transmitted infections", Grenoble, 2005). – 2005. – S. 165-169.
  5. Pankratov V. G., Pankratov, O. V. // Modern possibilities of laboratory diagnostics of syphilis andinterpretation of the results of the study. – Minsk, Belarusian medical Academy of postgraduate education, 2006.
  6. Pankratov V. G., Pankratov O. V., Krukovich A. A. and others // Health. – 2006. – No. 6. – P. 35-39.
  7. Rodionov A. N. // Syphilis: hands-on for doctors. – SPb.: Peter, 1997. S. 226-245.
  8. Jurado, R. L. // STD. – 1997. – No. 3. – P. 3-10.
  9. Schmidt, B. L. // the First Russian Congress of dermatovenerologists: proc. scientific. works. – SPb., 2003.– T. II. – Pp. 40-41.
  10. Romanowski, B., Sutherland R., Flick G. H. et al. // Ann. Med. -1991. – V. 114. – P. 1005-1009.