Syphilis: RPR With Reflex to RPR Titer and Treponemal Antibodies, Traditional Screening and Diagnosis Algorithm
CPT:
86592
Synonyms
- Nontreponemal Test
- Serological Tests for Syphilis (STS)
- Syphilis Serology
Test Includes
RPR, qualitative; RPR titer; and Treponema pallidum-specific test on reactives. An additional fee is charged when a confirmatory Treponema pallidum test is performed.
Expected Turnaround Time
1 - 2 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Documents
For more information, please view the literature below.
Improved Syphilis Reverse Screening Cascade: Earlier Detection With Fewer Ambiguous Results
Specimen Requirements
Specimen
Serum
Volume
2 mL
Minimum Volume
1 mL
Container
Red-top tube or gel-barrier tube
Storage Instructions
Maintain specimen at room temperature.
Stability Requirements
| Temperature | Period |
|---|---|
| Room temperature | 14 days |
| Refrigerated | 14 days |
| Frozen | 14 days |
| Freeze/thaw cycles | Stable x3 |
Causes for Rejection
Hemolysis; lipemia; gross bacterial contamination; plasma specimen
Test Details
Use
This test is intended to support screening and diagnosis of syphilis infections. This test aligns with the CDC-supported traditional serologic testing algorithm for syphilis using a combination of both treponemal and nontreponemal antibody tests. The traditional syphilis testing algorithm begins with the RPR (nontreponemal) test with positive samples reflexing to RPR titer and treponemal antibody testing. Interpretation of results obtained must take into account patient symptoms and clinical history.
Limitations
Biological false positive results (RPR-reactive, Treponemal antibody-negative) have been associated with infections other than syphilis, as well as recent immunization, autoimmune disorders, pregnancy and injection drug use.
Methodology
Charcoal flocculation and chemiluminescence immunoassay
|
Charcoal flocculation and |
|
Charcoal flocculation and chemiluminescence immunoassay |
Reference Interval
Nonreactive
Additional Information
| RPR | RPR titer | Treponemal Ab (TPAb) | Interpretation |
|---|---|---|---|
| Nonreactive | Not performed | Not performed | No laboratory evidence of syphilis. If recent exposure is suspected, submit a new sample for testing in 2-4 weeks. |
| Reactive | 1:1 or higher | Nonreactive | Nontreponemal antibodies detected. Syphilis unlikely; biological false positive possible. Clinical evaluation should be performed to identify current signs and symptoms or past history of infection or treatment. If recent exposure is suspected, submit a new sample for testing in 2-4 weeks. |
| Reactive | 1:1 or higher | Reactive | Treponemal and nontreponemal antibodies detected. Consistent with past or current (potentially early) syphilis. Clinical evaluation should be performed to identify current signs and symptoms or past history of infection or treatment. |
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