Syphilis Infection?

Illustration of Syphilis Infection?
Illustration: Syphilis Infection?

Connecting my question at the link: me-tertular-syphilis.nnThere the doctor said I could have had syphilis in the past so my VDRL was 1: 1. But I have never had syphilis before. NBecause my TPHA is non-reactive, then why is my VDRL Reactive? Please enlighten.

1 Answer:

Hello, RioMan, thanks for asking

Syphilis is a sexually transmitted disease that can cause symptoms such as painless genital sores, red rash, fever, and attacks the nervous system if not treated properly. The appearance of symptoms of syphilis depends on the stage of infection, there are primary, secondary, latent, and tertiary infections.

To diagnose syphilis, anamnesis (in-depth interview about the patient's history), physical examination, and investigations must be carried out. Investigations that can be done when a person is suspected of having syphilis are a dark field microscope test (to detect the germs that cause syphilis), which is done when the patient has syphilis suspected sores, as well as serological tests (tests that detect immune / antibody reactions against syphilis bacteria). ). This syphilis serology test is broadly divided into 2, namely the non-treponemal serology test and the treponemal serology test. The descriptions are as follows:

1. Non-treponemal serology: is a test used to detect the body's immune reaction to a substance that is formed indirectly during syphilis infection. Examples are VDRL and RPR. This test is not specific for treponema pallidum (the germ that causes syphilis), so a positive result can be a false positive (the test is positive but the person doesn't actually have syphilis). Conditions that can cause a false positive are other infections, pregnancy, and autoimmune conditions. However, this test is often used as an early detection in people who are suspected of syphilis, so that if the VDRL test result is positive, a further test is usually recommended, namely the treponemal serology test.

2. Treponemal serology: is a test used to detect antibodies that are formed if there are specific components of the syphilis bacteria in the body. These tests are more specific than non-treponemal ones and are often a test to confirm the presence of syphilis infection in the body. However, this test has a low sensitivity if it is checked when the patient has primary phase syphilis, so that in patients who are examined during the primary phase of syphilis, the test may show negative results (called false negative). Examples of treponemal serology tests are TPHA, TPPA, EIA, and CIA.

Regarding your test results, which are VDRL positive (reactive) and TPHA negative (non-reactive), it is likely due to a false positive result on the VDRL test as described above, or a false negative result on the TPHA result. However, to be more sure, you should check with your skin and genital specialist, because the results of the investigations must be adjusted to the history and results of direct physical examination.

That's all, hopefully it's useful.

Greetings, dr. Sarah Rizqia.

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