Appropriate Tests


Syphilis serology - serum. Screening EIA, followed by specific confirmatory assays (RPR, TPPA & FTA).

Primary syphilis

Syphilis test mucocutaneous ulcer; lesion fluid for microscopy or NAA testing.

Syphilis testing - serum or CSF should be repeated in 4-6 weeks if initially negative. Investigation for other sexually transmitted diseases (including HIV infection) should also be performed.

Syphilis is a notifiable disease; the source of infection should be traced.

  • Chancre


  • Lymphadenopathy (localised)


Secondary syphilis


  • Rash


  • Lymphadenopathy (generalised)


  • Condyloma latum


  • Mucous patches


Tertiary syphilis


  • Gumma


  • Aortitis


  • Neurosyphilis

Syphilis testing - serum or CSF.

Cerebrospinal fluid examination including microscopy, protein (oligoclonal bands), glucose.

Congenital syphilis

Syphilis serology - serum (mother and infant, including IgM in infant).

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