Syphilis : Tests

Blood tests can be done to detect substances produced by the bacteria that causes syphilis. The older test is the VDRL test. Other blood tests may include RPR and FTA-ABS.

There are several types of blood tests for syphilis presently used in the United States. Some are used in follow-up monitoring of patients as well as diagnosis. NONTREPONEMAL ANTIGEN TESTS. Nontreponemal antigen tests are used as screeners. They m...

MICROSCOPE STUDIES. The diagnosis of syphilis can also be confirmed by identifying spirochetes in samples of tissue or lymphatic fluid. Fresh samples can be made into slides and studied under darkfield illumination. A newer method involves prepari...

There are several types of blood tests for syphilis presently used in the United States. Some are used in follow-up monitoring of infected people as well as diagnosis. NON-TREPONEMAL ANTIGEN TESTS. Non-treponemal antigen tests are used with initia...

During a physical examination, a health care provider studies a patient's body to determine the presence or absence of physical problems. A typical physical examination includes: Inspection (looking at the body; Palpation (feeling the body with hands; Auscultation (listening to sounds; Percussion (producing sounds.

VDRL is a screening test for syphilis that measures antibodies that can be produced by Treponema pallidum, the bacteria that causes syphilis. The test is similar to the newer rapid plasma reagin (RPR) test.

In connection with syphilis control, the standard test for measuring nontreponemal antibodies is the Venereal Disease Research Laboratory (VDRL) test. In this test, heated serum or unheated cerebrospinal fluid is mixed with reagin (a purified mixture of lipids such as cardiolipin, lecithin, and cholesterol) on a glass slide, and flocculation, or clumping, of the mixture is read microscopically as "reactive" (if clumping occurs) or "nonreactive" (if there is no clumping). Like the rapid plasma reagin (RPR) test, the VDRL test can be quantitated by examining serial dilutions of serum and can be used to follow the course of illness, including the response to therapy. The VDRL usually becomes reactive within the first few weeks after infection, peaks during the first year, and then slowly declines, so that low titers (levels) are seen in late syphilis. It can revert to negative in the absence of treatment in about 25 percent of cases. Although regarded as the gold standard for the diagnosis of neurosyphilis, the VDRL test may be negative in 40 to 73 percent of patients. Recent immunization, other bacterial and viral infections, and certain chronic conditions (e.g., liver disease, malignancy) can result in false positive test results, though titers are usually low (less than 1:8 dilution) under these circumstances. J UDITH E. W OLF ( SEE ALSO : Antibody, Antigen ; Fluorescent Treponemal Antibody Absorption ; RPR Test ; Syphilis )

RPR (rapid plasma reagin) is a screening test for syphilis. It looks for antibodies that are present in the blood of people who have the disease. The test is similar to the venereal disease research laboratory (VDRL) test.

The rapid plasma reagin (RPR) test has several useful purposes. It is used to screen asymptomatic individuals for syphilis, diagnose symptomatic infection, and monitor disease activity and response to treatment. Unlike the fluorescent treponemal antibody absorption (FTA-ABS) test, which measures specific antibodies to the syphilis bacterium, the RPR test measures nonspecific antibodies that are produced when Treponema pallidum interacts with human tissue. These antibodies also cross-react with a purified mixture of lipids (cardiolipin, lecithin, and cholesterol), known as "reagin," which is used as the substrate in the RPR test. The RPR is a simplified version of the other nonspecific screening test for syphilis, the VDRL test. The RPR card test uses a mixture of reagin and carbon particles to which a patient's serum is added. Flocculation, or clumping, of the particles is read as a "reactive" or positive test. The test can be quantitated by examining serial dilutions of serum. A difference of two dilutions is required to demonstrate a significant difference between two tests. J UDITH E. W OLF ( SEE ALSO : Antibody, Antigen ; Fluorescent Treponemal Antibody Absorption ; Syphilis ; VDRL Test )

Viral and bacterial infections passed from one person to another through sexual contact. Adolescence is the period of transition from childhood to adulthood when profound changes occur. This period of tremendous change fulfills important developmental tasks in which the adolescent develops formal operational thought, builds cognitive decision-making skills, forms a sense of self-identity, and expresses the need for autonomy and individuation from the family. Adolescence is also a time of opportunities and risk, when many health behaviors are established. Although many of these behaviors are health-promoting, some are health-compromising, resulting in increasingly high rates of adolescent morbidity and mortality. For example, initiation of sexual intercourse and experimentation with alcohol and drugs are normative adolescent behaviors. However, these behaviors often result in negative health outcomes such as the acquisition of sexually transmitted diseases (STDs), including the fatal human immunodeficiency virus (HIV). As a consequence of STDs, many adolescents experience serious health problems that often alter the course of their adult lives, including infertility, difficult pregnancy, genital and cervical cancer, neonatal transmission of infections, and AIDS (acquired immunodeficiency syndrome). The acquisition and transmission of STDs among adolescents are influenced by complex interrelationships among sociodemographic, biologic, psychosocial, and behavioral factors. For example, many STD-related risk markers (e.g., age, gender, race/ethnicity) correlate with more fundamental determinants of risk status (e.g., access to health care, living in communities with high prevalence of STDs) to influence adolescents' risk for STDs. Developmental factors such as pubertal timing, self-esteem, and peer affiliation may also increase their risk of exposure to STDs. An assessment of these interrelationships are critical to preventing and controlling STDs in adolescents, yet they are poorly defined and understood. Moreover, since behavior is the common means by which STDs occur, an important first step in fighting STDs is to understand the prevalence and patterns of risk behaviors as well as the psychosocial context in which these behaviors occur.

Sexually transmitted diseases (STDs) are viral and bacterial infections passed from one person to another through sexual contact.

Sexually transmitted disease (STD) is a term used to describe more than 20 different infections that are transmitted through exchange of semen, blood, and other body fluids; or by direct contact with the affected body areas of people with STDs. Sexually transmitted diseases are also called venereal diseases.

Sexually transmitted diseases (STDs) are caused by a group of infectious microorganisms that are transmitted mainly through sexual activity. These agents represent a costly, burdensome global public health problem. STDs can cause harmful, often irreversible, clinical complications, including reproductive health problems, fetal and perinatal health problems, and cancer, and they are also linked in a causal chain of events to the sexual transmission of human immunodeficiency virus (HIV) infection. Although STDs are largely preventable through behavior modification and sound primary health care, they are under-recognized and under-appreciated as a public health problem by most healthcare providers, the general public, and healthcare policy makers. In 1997, the Institute of Medicine characterized STDs as "hidden epidemics of tremendous health and economic consequence" in the United States and advocated urgent national preventive action. An estimated 333 million curable STDs occur annually worldwide. In the United States, STDs are among the most frequently reported infectious diseases nationwide. Each year an estimated 15 million new cases of STDs occur in Americans, including nearly 4 million infections in U.S. teenagers. The annual direct and indirect costs of the principal STDs, including sexually transmitted HIV infection, and their complications are estimated at $17 billion. More than twenty-five bacteria, viruses, protozoa, and yeasts are considered sexually transmissible. Bacterial STDs include those caused by Chlamydia trachomatis (chlamydia), Neisseria gonorrhoeae (gonorrhea), Treponema pallidum (syphilis), Haemophilus ducreyi (chancroid), and other common sexually transmitted organisms. Chlamydia and gonorrhea cause inflammatory reactions in the host. In women, these organisms can ascend into the upper reproductive tract where pelvic inflammatory disease (PID) can cause irreparable damage to the reproductive organs and result in infertility, ectopic pregnancy, and chronic pelvic pain. In its early stages, syphilis causes painless genital ulcers and other infectious lesions. Left untreated, syphilis moves through the body in stages, damaging many organs over time. Chancroid is associated with painful genital lesions. In pregnant women, acute bacterial STDs can cause potentially fatal congenital infections or perinatal complications, such as eye and lung infections in the newborn. Effective single-dose antimicrobials can cure chlamydia, gonorrhea, syphilis, and chancroid. Viral STDs include the sexually transmitted viral infections caused by human immunodeficiency virus (HIV infection), herpes simplex virus type 2 (genital herpes), and human papillomavirus (HPV infection). Initial infections with these organisms may be asymptomatic or cause only mild symptoms. Treatable but not curable, viral STDs appear to be lifelong infections. HIV is the virus that causes acquired immunodeficiency syndrome (AIDS). Herpes causes periodic outbreaks of painful genital lesions. Some strains of HPV cause genital warts, and others are important risk factors for cervical dysplasia and invasive cervical cancer. Hepatitis B virus (HBV) is another acute viral illness that can be transmitted through sexual activity. Most persons who acquire HBV infection recover and have no complications, but it can sometimes become a chronic health problem. Trichomonas vaginalis (trichomoniasis) is a common protozoal STD, and Candida species (candidiasis) are sexually transmitted yeasts. Both are frequently associated with vaginal discharge.

Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum . Tests for syphilis can be either treponemal (identifying an antibody that occurs specifically in T. pallidum infection ) or nontreponemal (identifying a nonspecific antibody that is present in a variety of infectious diseases, including syphilis). Treponemal tests include the fluorescent treponemal antibody-absorbed double stain test (FTA-ABS DS) and the microhemagglutination- T. pallidum test (MHA-TP). The most common diagnostic tests used to diagnose syphilis are the nontreponemal tests called the rapid plasma reagin test (RPR) and the Venereal Disease Research Laboratory test (VDRL). These two tests are both reagin flocculation tests used to verify that an antigen-antibody reaction has occurred.

FTA-ABS is a blood test is used to detect antibodies to the bacteria Treponema pallidum, which causes syphilis. This test is used to confirm whether a positive screening test for syphilis means there is a true infection.

The fluorescent treponemal antibody absorption (FTA-ABS) test measures a specific antibody made against Treponema pallidum , the bacterium that causes syphilis. The test is reserved for confirmation of a positive screening test for syphilis and distinguishes patients with true infection from those with a false positive result of a screening test. Once a person tests positive, he or she will usually test positive for life. Therefore, the test cannot be used to measure disease activity or differentiate past from present infection. The FTA-ABS is performed by first heating a patient's serum and mixing it in an extract of nonpathogenic treponemes called "sorbent." This step removes any cross-reacting antibodies that may have developed against treponemes that naturally reside in the human mouth or genital tract. The serum is then layered onto slides containing T. pallidum . Anti-human antibodies labeled with a fluorescent indicator are added, and the slides are examined under a fluorescent microscope. The intensity of fluorescence is quantified using a one (weakly positive) to four (strongly positive) scale. Though very sensitive and highly specific for syphilis, this test tends to be expensive, subjective, and time-consuming, as it requires interpretation by an experienced technician. J UDITH E. W OLF ( SEE ALSO : Antibody, Antigen ; RPR Test ; Syphilis ; VDRL Test )