Syphilis test by Lucinete Messina

The laboratory diagnosis of syphilis is based on microscopy and serological tests.
Microscopy: Identification of the causative agent, Treponema pallidum, can be performed with an adequate collection of material in the recent lesions (primary and secondary phases) by the dark field microscopy technique or by direct immunofluorescence, and it is possible to observe the live and furniture.
Serologies:
Non-treponemic serology: VDRL and RPR.
Treponemal serology: FTA-abs, MHA-Tp or TPHA, ELISA.
In congenital syphilis, in addition to the above examinations, a complete blood count, X-ray of long bones and examination of cerebrospinal fluid or cerebrospinal fluid (CSF) should also be requested for cellularity, proteins and VDRL. The VDRL of the newborn within the case definition should be performed with blood taken from the peripheral vein rather than from the umbilical cord. Treponemal exams may be reactive up to the 18th month of life, due to the passivity of maternal antibodies, and are rarely used for the diagnostic definition in children up to this age.
In congenital syphilis, the involvement of several organs and systems suggests that a differential diagnosis be performed with a blood test to detect the presence of pathogenic organisms and other congenital infections such as rubella, toxoplasmosis, cytomegalovirus, generalized herpes simplex virus infection and malaria . Later lesions may also be confused with measles, chickenpox, scarlet fever, among others. Serologies should be requested for treponemics and non-treponemics.

Quick Test for Syphilis
The rapid test for syphilis is an immunochromatographic, treponemal, single use test for the detection of antibodies specific for Treponema pallidum. It can be done with whole blood, serum or plasma.
Within the proposal to increase access to diagnosis, the rapid test for syphilis is used in special situations and as screening.
The Flowchart for Syphilis Research Using Rapid Treponemal Test of Ordinance No. 3.242, of December 30, 2011, its corrections should be followed. According to the flowchart, obtaining a reagent result in the rapid test for syphilis, there is a need to collect the sample by venipuncture and send it to the laboratory so that the Laboratory Flow Chart for Syphilis Research is performed (Portaria nº 3.242). In specific situations, as an exception, there is a recommendation for treatment only with the result of the rapid reagent test. These situations are set out in the Syphilis Quick Test Manual.
The Department of STDs, AIDS and Viral Hepatitis uses the following Syphilis tests: the Rapid DPP Syphilis Test and the Rapid Check Syphilis Rapid Test.