* It is important to ensure that all patients with prior syphilis have been adequately treated.
¶ Nontreponemal tests include the rapid plasma reagin (RPR), the Venereal Disease Research Laboratory (VDRL), and the toluidine red unheated serum test (TRUST).
Δ Treponemal tests include the fluorescent treponemal antibody absorption (FTA-ABS), the Treponema pallidum particle agglutination (TPPA), the T. pallidum enzyme immunoassay (TP-EIA), or chemiluminescence immunoassay (CIA). These different tests target different antigens.
◊ Treatment of syphilis depends upon the clinical manifestations and the stage of disease (eg, early, late, neurosyphilis). For those with prior syphilis, results of prior nontreponemal tests are also used to guide treatment decisions. Refer to the UpToDate topic on treatment of syphilis.
§ If a patient with prior treated syphilis had an initial treponemal test performed, this pattern (reactive treponemal test/nonreactive nontreponemal test) is expected.