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Treponema Pallidum (Syphilis) Screening Cascade Blood Test

The Treponema Pallidum (Syphilis) Screening Cascade test screens for and diagnoses syphilis.


Test Code: 082345

CPT Code: 86780

Also Known As: Syphilis Test; Syphilis Antibodies; Trep-Sure™; Treponemal; Reponema Ab; Treponema Pallidum; Reverse Algorithm; T. Pallidum; Treponema Pallidum Antibodies

Methodology:

Enzyme Immunoassay (EIA) with Reflex to Charcoal Flocculation if Reactive

Preparation:

No special preparation is required.

Test Results:

2-5 days. May take longer based on weather, holiday, or lab delays.


Details:

This test includes a reflexive qualitative RPR Screen on positive Treponema Pallidum Antibody results.


Test Code: 90349

CPT Code: 86780

Also Known As: Syphilis Test; Syphilis Antibodies; Trep-Sure™; Treponemal; Reponema Ab; Treponema Pallidum; Reverse Algorithm; T. Pallidum; Treponema Pallidum Antibodies

Methodology:

Immunoassay (IA)

Preparation:

No special preparation is required.

Test Results:

2-5 days. May take longer based on weather, holiday, or lab delays.


Details:

This test includes a reflexive RPR Screen on positive Treponema Pallidum Antibody results. If the RPR Screen is reactive, then the RPR Titer will be performed. However, if the RPR Screen is non-reactive, then Treponema Pallidum Antibody, Particle Agglutination will be performed.

Description

A highly contagious infection caused by the Treponema pallidum bacteria, Syphilis is one of the most common sexually transmitted diseases (STD). The syphilis infection is transmitted through contact with a syphilitic sore, known as a chancre, usually during sexual intercourse (vaginal, anal, or oral). Sometimes, Syphilis is transmitted from a parent to a child during fetal development or childbirth. 

This Treponema Pallidum (Syphilis) Screening Cascade test screens for and diagnoses Syphilis. First, an initial test is performed to screen for treponemal antibodies that cause a Syphilis infection. Then, a reflexive Rapid Plasma Reagin (RPR) test will be performed if these antibodies are detected to confirm the patient's diagnosis.

It is important to note that treponemal antibodies are usually produced within three to six weeks of infection. In addition, a person can still test positive for treponemal antibodies after completing syphilis treatment. Therefore, a treponemal antibodies test alone cannot differentiate between a current or past infection. However, the results will be confirmed if performed in conjunction with an RPR test. Therefore, this test can be used for initial screening, confirmation, and continued monitoring.

If not appropriately treated, Syphilis may progress through three stages: primary syphilis, secondary syphilis, and tertiary syphilis, and cause severe damage to internal organs. Therefore, the signs and symptoms of Syphilis differ according to the stages of infection:

  • During the primary syphilis stage of infection, one or more chancres may appear near the infected area, such as the penis, vulva, or vagina.
  • As the infection progresses to the secondary syphilis stage, the infected individual may experience:
    • Enlarged lymph nodes
    • Skin rash on the palms or the soles of the feet
    • Skin growths near moist areas of the skin (mouth, armpits, genitals, and anus)
    • Fever
    • Tiredness
    • Decreased appetite
    • Extreme weight loss
  • Once the infection reaches the tertiary syphilis stage, the individual may experience life-threatening symptoms, such as:
    • Inflammatory masses, known as gumma, of the skin, bones, or internal organs
    • Deep bone pain
    • Heart damage

The syphilis infection may spread to the brain and nervous system at any stage, causing neurosyphilis. However, in rare cases, the disease may reach the eyes or ears, resulting in ocular syphilis or otosyphilis. 

Individuals may order this test if they are experiencing syphilis symptoms, have an increased risk of infection, or for initial screening, confirmation, and continued monitoring. Contact your doctor or healthcare provider if you have significant concerns or questions about your recent lab results.

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