What analysis is taken for syphilis. Analysis for syphilis: what is it called, how much is done, when to take it. Preparatory measures before the examination

An analysis for syphilis is an important diagnostic method that allows you to identify the presence of a pathogen in the body in the early stages, when venereal disease can be cured in a short time. The infection caused by pale treponema is dangerous for the development of serious disorders in the functioning of systems and organs that are difficult to recover even after the complete destruction of pathogenic microorganisms.

What tests are given for syphilis

Exist various ways detection of syphilis in the laboratory. As biological material can be used:

• blood from a vein and a finger;
• liquid secreted by hard chancres;
• tissues of the regional lymph node;
• liquor.

The research method is selected taking into account the symptoms and stage of syphilis.

General analysis blood does not allow the diagnosis of treponemal infection. In the early forms of the disease, laboratories use a bacterioscopic technique that helps to detect a pathogenic microorganism using a microscope. Serodiagnostics is also used, based on the detection of the pathogen antigen and immunoglobulins synthesized by the body in response to infection. The bacteriological type of research in case of suspected syphilis is not carried out, since the growth of the pathogen when placed in nutrient media in the laboratory is insignificant.

As diagnostic methods the following tests apply:

1. Non-treponemal, which include the Wasserman reaction (RW), the test with toluidine red, the microprecipitation reaction (MP or RMPA), the plasma reagin test (RPR).
2. Treponemal, including passive hemagglutination reaction (RPG), immunoblotting, enzyme immunoassay (ELISA), immunofluorescence reaction (RIF), treponema immobilization reaction (RIT).

When screening pregnant women, routine examinations, non-specific express tests are prescribed. In the presence of symptoms of a sexually transmitted disease and positive results obtained by non-treponemal methods, additional studies are carried out using highly sensitive test systems.

Most Effective

Currently, the analysis for RW syphilis is practically not carried out. As a more effective test in laboratories, the microprecipitation reaction is used. The main disadvantage of the method is its low specificity, since it can show a false positive result in conditions such as:

• pregnancy;
• blood diseases;
• systemic lupus erythematosus;
• menses;
• the period after childbirth;
• tuberculosis.

Upon receipt of positive results before conducting drug therapy the patient is assigned a blood test by specific methods. RIF and RIT are considered the highest quality today. These tests require a technical base and well-trained personnel. They differ from non-treponemal methods in relative complexity, time-consuming reactions, and high cost of reagents. The RIF indicator becomes positive 60 days after the introduction of the infection.

To exclude or confirm the diagnosis, doctors prescribe an RIT analysis, which allows you to accurately determine the presence of pale treponema in the body. A positive result can be obtained 2-3 months after infection.

An effective specific test is ELISA. It allows a diagnosis to be made 21 days after infection. Like other methods, enzyme immunoassay can give false positive reactions that are observed in autoimmune processes, changes associated with impaired metabolism.

How to prepare for the analysis

In order for the test to show an accurate result, some preparation is necessary.

There are factors that can affect the data obtained: addiction to alcohol, fatty foods, smoking, a number of medicines taking material on a full stomach.

Donating blood for syphilis requires compliance with the following rules, which the doctor must familiarize with when issuing a referral:

1. The biomaterial is given by the patient on an empty stomach, mainly in the morning. The last reception is carried out no later than 21 hours, while the food should be light, with a minimum fat content.
2. Before the procedure, it is allowed to drink a small amount of clean boiled water. Drinks containing gases are not allowed. Coffee, black and green tea prohibited.
3. The patient must inform the doctor who issued the referral for the study about taking medications. If necessary, blood donation can be scheduled for another time if taking the medication is vital.
4. For 5-6 days it is forbidden to take alcohol-containing drinks.
5. Do not smoke immediately before the biomaterial sampling procedure.

In many public and private clinics, blood is taken up to 14 hours, after which the material is sent to the laboratory for analysis.

Accuracy and reliability of results

To date, there is no single laboratory treponemal or non-treponemal test that gives an absolute guarantee that the data is reliable. Therefore, during a general examination of the patient, non-specific tests for syphilis are primarily prescribed. If a person has signs of a sexually transmitted disease, contacts with syphilitic patients, the doctor prescribes additional diagnostics based on specific tests.

False positive tests during the precipitation reaction (RMPA) are possible under the following conditions:

• acute infectious process;
• strokes and heart attacks;
• injury;
• acute intoxication;
• rheumatic disease;
• neoplasms of a malignant nature;
• diabetes;
• liver damage.

The primary form of syphilis is detected in RMPA in 80% of cases, the secondary - in 98%.

The passive haemagglutination test is highly specific and is used as a confirmatory test after a positive test is obtained using other diagnostic methods.

The study of serum using RIF gives an erroneous result in extremely rare cases. The RIT method is used for suspected latent syphilis and helps in establishing the fact of the disappearance of treponemal infection.

How much is the analysis for syphilis

To obtain indicators using the microprecipitation reaction, two to three hours are sufficient. This method shows the presence or absence of syphilis in a patient. To obtain a detailed (quantitative) assessment of serum for the content of immunoglobulins in it, a longer period of time is required.

IN public clinics with a high workload of laboratories, the analysis is prepared in 3-7 working days. In private diagnostic centers with their own equipment, the result can be obtained the next day.

Deciphering the result in the state medical institution given by the doctor at the time of re-admission. Paid laboratories have the ability to send data to the patient's email.

How long does the analysis work

In order to find out the validity period of tests for syphilis, you need to contact the specialists of the medical institution.

In different laboratories, the time during which the results are valid can vary from one to three months.

The duration of the RW analysis also depends on its purpose:

Decoding: norms and deviations

A study using the Wasserman reaction can produce the following results:

• "+++" - sharply positive;
• "++" - weakly positive;
• "-" - negative (normal);
• "+" - doubtful.

When receiving a result with one “+”, doctors recommend checking for the presence of a treponemal infection after 14 days. Indicators may change if the day before the patient took medications, drank alcoholic beverages, had an acute viral infection.

False-negative non-treponemal analysis in the presence of positive indicators obtained by ELISA and RPHA, indicates late stage syphilis or a cured disease.

Analysis cost

In public clinics, non-treponemal tests are performed free of charge for patients. The referral is issued by a general practitioner or venereologist. Specific tests can be done at pay centers equipped with laboratory equipment. The cost of services varies from clinic:

1. In Invitro, a blood test for treponemal infection using an anticardiolipin test is carried out for $ 9.8, including the price for taking venous blood. If necessary, for an additional fee, analyzes can be done urgently - in 2 hours, not counting the time of sampling of biological material.
2. In Sinevo, ELISA tests can be done for $ 8.8. The cost also includes the collection of biological material.
3. In CMD laboratories, you can take an anticardiolipin test for $6.1. The turnaround time for results is 1 calendar day. Urgent tests are more expensive - $ 12.1. Results are issued within 3-5 hours.

Syphilis testing using treponemal and non-treponemal test systems is the most important diagnostic procedure, allowing to detect the infection as soon as possible and proceed with immediate drug therapy. Modern methods help to identify congenital syphilis and prevent the development of complications.

When obtaining a positive result using one type of study, it is important to conduct additional tests based on quantitative estimates.

Treatment antibacterial drugs is prescribed only after receiving positive indicators by several laboratory methods. Lack of therapy leads to serious violations of the functions of internal organs and systems.

Logon is a modern medical center equipped in accordance with all requirements recent years. Logon really meets the highest standards and deserves comparisons with leading European clinics.

Logon works in close cooperation with the laboratory, which has the most modern technical equipment. By contacting this medical center with suspected syphilis, you will be able to donate blood as soon as possible. The best doctors will test for the detection of antibodies to syphilis in the blood and immediately acquaint you with its results. The procedure will be completely painless.

The medical center has a strict procedure for collecting tests for syphilis. The patient must necessarily donate blood in the morning, abstaining from food before that for at least 8 hours. You can drink water, but in small quantities. Blood is taken from a vein; it is impossible to replace the analysis with taking blood from a finger.

The doctor will notify the patient about the presence of a number of factors that may distort the result of the analysis. If the sick client has diabetes, pneumonia, or is a pregnant woman, the test may show the presence of syphilis even if it is not present. In this case, a second analysis will be carried out, which will give a more reliable result.

The main advantage of the Logon center is the desire of its employees to help each patient. Logon works without interruption on holidays and weekends. The client can receive the required assistance at any time.

Service in Logon is characterized by low prices. An analysis that confirms or refutes the presence of syphilis in a patient will cost him no more than 2,000 rubles. Anyone can check the exact prices at the registration desk. medical center or its call center, which can be contacted at +7 495 921-35-68.

About testing for syphilis

Syphilis is an insidious disease that manifests itself in individual symptoms in each patient. Detecting it through a blood test is not an easy task. To determine syphilis, doctors will certainly need blood from the patient's vein, his cerebrospinal fluid, ulcer discharge, and fragments of lymph nodes.

Classification of methods for laboratory diagnosis of the disease

At the beginning of work with a new patient, the doctor can apply the bacterioscopic method. Its essence lies in the search for pale treponema, which is the causative agent of syphilis. After that, the doctor proceeds to serological tests. But the bacteriological method in determining syphilis will be completely useless, because treponema does not grow in artificial conditions, even while maintaining its life support systems with the necessary nutrient medium.

Modern methods of searching for treponema are usually divided into two groups: direct and indirect. Direct methods are simpler. In the case of them, doctors are trying to detect the microbe itself in the biological material obtained. Direct methods include:

• dark field microscopy;
• RIT test, which assumes that guinea pigs will be infected with the material obtained from the patient;
• PCR showing areas of the treponema genetic trace.

Indirect methods, also called serological methods, are not based on the search for treponema. Their task is to find antibodies produced by the body itself to fight the microbe. Indirect methods are usually divided into non-treponemal and treponemal. These techniques are very complex, and in Russia there are few specialists who can carry them out at a sufficiently high level.

Direct Tests

One of the most reliable ways to diagnose syphilis is considered to be the search for treponema under a microscope. If treponema is detected, the doctor can report with 97% certainty that the patient has syphilis. However, the absence of treponema in the biological material does not mean that the patient is healthy. This causative agent of syphilis is found only in 80% of patients.

This diagnosis is carried out twice: after the first visit of the patient to the clinic and after the appearance of skin rash or visible chancre. It is in the material obtained from them that the search for treponems will be carried out.

A more reliable, and therefore more expensive analysis is the search for treponema under a microscope, in which the material is processed with fluorescent antibodies. It is their high cost that increases the price of analysis. However, it is difficult to overestimate the importance of these antibodies: they find treponemas, stick to them and highlight the affected areas in such a way that it will definitely be visible under a microscope.

This method will be especially effective at an early stage of the disease. Its reliability is reduced if syphilis has progressed or has been exposed to some drugs or antiseptics.

The RIT test discussed above is another reliable way to diagnose syphilis. But it has one significant drawback. Until the first symptoms begin to appear in a rabbit infected with the patient's biological material, a lot of time will pass, and with syphilis, every minute is precious to the patient.

Non-treponemal tests

One of the most popular non-treponemal tests is the Wasserman test. This is a fast and relatively reliable way to diagnose syphilis in a patient. For its implementation, antibodies are isolated from the patient's blood, which are exposed to treponema and cardiolipin. As a result of the experience, the antibodies are modified, flakes should form, which will become a reliable evidence of the presence of syphilis.

In Russia, the Wasserman reaction did not gain wide popularity. Domestic specialists are more fond of its analogue - the reaction of microprecipitation. They attribute the lack of the Wasserman reaction to the frequent receipt of false positive results caused by the presence of other diseases in the patient. Therefore, even if the Wasserman reaction gives a positive result, doctors are in no hurry to inform the patient that he has syphilis, but turn to additional and more accurate diagnostic methods.

The Wasserman reaction is capable of detecting syphilis only 2 months after the patient is infected. The reaction of microprecipitation has similar terms. In addition, it can also give a false positive result, albeit not so often.

Can a syphilis test be wrong?

The analysis for syphilis can indeed be erroneous. Moreover - in medical practice this happens quite often. Even the most reliable non-treponemal method - RMP - sometimes gives an unreliable result. Most often this is due to the fact that the patient is not sick with syphilis, but with another disease. Tuberculosis, brucellosis, leptospirosis, diabetes mellitus, cancer, pregnancy, postpartum condition, cirrhosis, and many other medical conditions can give a false positive result. When physicians are in doubt about the results of non-treponemal tests, they inevitably have to seek help from treponemal tests.

Treponemal tests

One of the most popular treponemal tests in the entire miter is the rapid plasma reagin test. For its implementation, doctors use cardiolipin antigen.

Slightly less popular, but also widespread in the world, is the test with toluidine red. These treponemal methods not only allow the diagnosis of syphilis, but also give the doctor information about how effective the treatment he proposed can be.

After completion of the treatment course, doctors use non-treponemal tests. They are ideal for diagnosing the absence of disease. If the test gives a negative result, with 99.9% certainty we can assume that it is correct, and the patient really no longer has syphilis. These tests will make sense no earlier than 3 months after the full completion of the course of treatment.

Rules for obtaining an analysis for syphilis

In order to get a referral for an analysis diagnosing syphilis, the person who wishes should contact the therapist at the place of his residence, and he will write out required document. Given the speed of free medicine in Russia, there is a way to do it faster and contact a private laboratory directly.

Lack of food 8 hours before the analysis is the main, but not the only condition for its successful implementation. It is equally important for 2 days to completely eliminate any fatty foods and alcohol from your diet.

The test is taken from the cubital vein, but some laboratories also take a blood sample from a finger.

Tests for syphilis do not take much time from doctors. A paid laboratory will acquaint the patient with their results the very next day. A blood test for syphilis will be valid for no more than three months.

If the analysis confirmed the presence of syphilis in the patient, he should contact a dermatovenereologist at the place of registration or choose a specialist from a paid medical center who, after analyzing all the available information, will prescribe the right course of treatment.

Syphilis is an infectious disease caused by treponema pallidum spirochete. This microorganism is easily spread through sexual or close household contact. It strikes internal organs, breeds quickly, but does not "like" high temperatures and dryness. At low temperatures, as well as moisture, treponema is able to survive and multiply.

Ways of contracting syphilis

Syphilis is spread through:
- sexual contact
- mother's milk to the child during feeding
- intrauterine contact
- household method (use of the same household items)
- saliva
- patient's blood

Types of syphilis

By origin, congenital or acquired is distinguished.
According to the stage of the disease - primary, secondary, tertiary.
Depending on the time of occurrence, they are divided into early / late syphilis.

Treatment of syphilis

Who should treat syphilis, how long does the treatment last?

Syphilis is treated by a dermatovenereologist. The process of treating syphilis is quite long. If early syphilis is detected, treatment takes about two or three months, if syphilis is late, then the treatment process can take two or more years. Strict abstinence from sexual life and utmost care in everyday life in relation to cohabitants are observed. All of them are shown prophylaxis in order to avoid infection.

What does the treatment of syphilis consist of and is it possible to be cured by non-traditional methods

by the most effective method treatment for syphilis is intravenous administration penicillin drugs in a hospital under the supervision of a doctor. The course of treatment is 24 days. The agent is injected every 3 hours. If the patient is allergic to these drugs or treatment is ineffective, tetracyclines are prescribed. Additionally, the patient undergoes immunotherapy and takes vitamins.

How not to get syphilis to family members

It is quite easy to catch syphilis, especially if it is manifested on skin. Therefore, the patient must have his own household items (dishes, towels, soap, bedding, etc.). At the stage of infection, there should be no bodily contact with the patient.

You can plan a pregnancy after being treated for syphilis

It is possible to plan a pregnancy, provided that the woman has been carefully treated, the doctors have diagnosed a complete recovery and deregistered. And even in this case, it is first necessary to be examined, and examinations are also carried out during pregnancy. It will be useful to undergo preventive therapy.

A syphilis test has long been included in routine medical supervision. Pregnant women are prescribed this analysis without fail before the hospital. The results of the study may be required during medical examination, as well as in some organizations when applying for a job. Laboratory diagnostics syphilis currently has a good level of development, but despite this, new cases of the disease appear every year.

General description of the disease

Syphilis is caused by the bacterium Treponema pallidum, or, in other words,.

If it enters the body, then all internal organs will gradually become infected, and outside the body this bacterium dies very quickly from disinfectants or even ordinary sunlight. And only a humid environment and freezing preserve its strength.

The need for analysis

Ways of infection:

At the time of blood collection at transfusion points, all tests for disease detection are carried out, thus, most of the cases of past syphilis infection in the present are prevented.

Stages of the disease

The first symptom of the disease is called syphiloma and looks like a seal with a small ulcer or erosion on the skin. Usually, the formation appears at the site of entry of the bacteria into the body. Since most often the disease is transmitted sexually, traces of the disease occur on the skin of the genitals or perineum.

After a certain time, the seal disappears, and the patient may think that the disease has passed by itself, but after 1.5 months it appears in the same place, which can last for several years. This is already manifested by the secondary stage of syphilis. The problem of diagnosing the disease is that the primary and secondary stages bring practically no discomfort, except for skin manifestations, the sore and rash disappear without a trace, so carriers may not be aware of the disease, because not everyone goes to the doctor because of skin rashes.

There is also a tertiary stage of syphilis, it overcomes all organs and tissues, and the appearance of gums - dense nodes that fall off on their own and leave rough scars, indicates a decrease in antibodies to this disease so much that serological diagnosis cannot detect infection. Many, of course, resort to examination by a doctor, but not everyone can talk about love partners and even more so invite them for diagnosis.

Diagnostic methods

To detect the presence of a disease or determine its absence, there are the following diagnostic methods and types of tests.

General blood test for syphilis

A complete blood count for syphilis (Wassermann reaction) is the most popular immunological reaction in detecting this disease. The study is abbreviated as RW and was first conducted in 1906. The Wasserman reaction belongs to the class of complement fixation reactions (RCC). It is based on the fact that the patient's blood has the ability to clot and form a complex in interaction with antigens. At the same time, modern RSK methods in detecting syphilitic infection differ significantly in antigens from the classical RW, but the term for this type of examination has traditionally been retained.

Antibodies that are produced by the body in response to the appearance in it of the causative agent of the disease - the cardiolipin antigen, are evidence of the presence of the disease and are determined using RW.

You need to know that the last meal should not be taken earlier than 6 hours before donating blood, that is, you cannot eat immediately before the analysis. The sampling is carried out in the doctor's office from the cubital vein, from where the biomaterial is taken for analysis, and 8-10 ml of blood will be needed. The rules for donating blood to detect syphilis warn that the patient does not drink alcohol 1-2 days before visiting the doctor. In addition, it is necessary to refrain from eating fatty foods, which can distort the results of the test.

Despite a qualitative diagnosis, the patient may have a result associated with the fact that there is cardiolipin in the human body, but the immune system usually does not create antibodies against the native antigen. Despite these circumstances, there are exceptions to this rule. Most often this happens due to recent transfer viral diseases severe form and some other diseases and conditions:

• pneumonia;
• kidney and blood diseases;
• malaria;
• , in other words, during a period of strong weakening of the immune system.

If the specialist suspects that the result is a false positive, they may refer the patient for an additional extended analysis, which is performed for diseases that are sexually transmitted.

Microprecipitation reaction

At present, the above method is increasingly replacing the microprecipitation reaction (RMP). This method is quite simple and more accurate - if the blood is infected, then white flakes will appear during the test.

RIBT method

Another view laboratory research- reaction of immobilization of pale treponemas (RIBT). A generally accepted condition for a correct result is the elimination of antibiotics before diagnosis, which have an effect on pale treponema, causing their incomprehensible inactivity.

Positive RIBT responses appear approximately from the middle of the secondary stage of infection and can be stored for a long time after treatment. In addition, this method is used to study antibodies in the CSF, this diagnosis is distinguished by high specificity, but very low sensitivity (almost 40%).

RIF research

Sometimes an immunofluorescence reaction (RIF) is performed. There are a number of RIF modifications: RIF-c - to detect antibodies in the CSF, RIF-200 (the test material is diluted 200 times before analysis), RIF with absorption, IgM-RIF-abs (for formulating IgM antibodies).

In terms of sensitivity and specificity, RIF-abs is not inferior to RIBT, but the execution of this test is much simpler. The RIF-abs responses will be positive from the 3rd week of the disease (before the appearance of a hard chancre or with it), this is a method for early investigation of syphilis. Quite often there are positive responses to tests many years after the treatment of early infection, and in patients with late syphilis - for decades.

RPR testing

Not everyone knows how RPR is tested for syphilis. RPR test with rapid plasma reagins is a foreign analogue of the RMP test.

These tests are quite good, but due to false positive results, a detailed analysis is necessary:

• RSKt;
• RPGA;
• immunoblot.

ELISA for syphilis

The method is 95% sensitive and quite economical, but sometimes the result is false positive. Therefore, it is carried out twice, confirming with a test for syphilis RPGA.

Superiority of ELISA: reaction automation, good degree of standardization. This method exhibits good sensitivity in early diagnosis syphilis, and in the study of congenital disease. ELISA is very convenient in testing blood in transfusion organs.

This diagnostic option also has disadvantages: unsuitability for the study of single samples, a long time to obtain a result. At the same time, ELISA kits have a short shelf life.

RPHA (passive hemagglutination reaction) is carried out both in qualitative and quantitative form. quantitative method determines the concentration of antibodies in the blood, which allows you to find out how long the disease has. IN clinical practice this method is leading due to its specificity, simplicity and standardization of reagents.

The immunoblot test for syphilis is one of the modern tests for determining the disease. Very good sensitivity, reproducibility and specificity make it possible to study the spectrum of antibodies to several antigens at once infectious disease. It is immunoblotting that has a more accurate sensitivity for determining the disease in the secondary stage of the disease; in the very first days of a newborn's life, this method can reveal a latent form of congenital syphilis. The immune blot copes with the identification of false positive tests other types of research of a pale treponema.

Terms of obtaining the results of the analysis

Most often, blood is used as a biomaterial for testing; sometimes, with certain diseases, a urine test or a smear from the vagina may be required. Some laboratories take several biomaterials for testing at once if there are certain complaints. But how long the test is done in time depends on the test option. Basically, the study is carried out for about a week, this is in free laboratories. If you need an urgent answer, then you need to contact a paid clinic, where the result can be provided in 1-2 days, and there is also the opportunity to order an emergency check. Results will be ready within 2 hours.

carried out with the help of specific tests? Such studies include ELISA, RIF, RIBT, and immunoblotting. During these seroreactions, the binding of the antigen-antibody complex occurs with the participation of treponemal antigens.

Treponemal tests become informative a little later than non-treponemal tests - 15-30 days after the pathogen enters the body. ELISA and RIF are highly accurate and specific methods for the immunodiagnosis of syphilis. During the study, antitreponemal antibodies bind to the antigen. 10-14 days after infection, IgM immunoglobulins begin to appear in the blood serum, after 25-30 - IgG.

RPHA can be used 30 days after infection. As a rule, it is used in combination with the microprecipitation reaction and. Its use allows you to confirm a syphilitic infection at any stage. An increase in titers means activation of the pathogen and recurrence of the infection; with a latent course, the titers are reduced. In people, even those who have been treated and cured of syphilis, the results of RPHA remain positive throughout their lives.

The RIBT immobilization test is the most accurate method of serosurvey for syphilis. It allows you to accurately differentiate false-positive test results from true positive ones. To finally verify the diagnosis in the latent course of the disease, as well as to confirm or exclude the disease in pregnant women upon receipt of positive test results.

However, it becomes informative later than other standard immune reactions to syphilis.

If you need to undergo a diagnosis of syphilis, contact a competent venereologist.

A syphilis test detects the presence of antibodies to the bacteria that cause syphilis in the tissues or blood of the body.

Syphilis is a sexually transmitted disease, that is, through sexual intercourse, oral sex, or kissing.

What tests are given for syphilis?

Tests to detect the disease include:

• a special test for the presence of human-produced antibodies in the body;
• rapid tests for plasma reagins;
• enzyme immunoassay (most new analysis blood for syphilis).

All test results for syphilis show the presence of antibodies to bacteria, disease-causing.

Analyzes are carried out in order to:

• detection of syphilis;
• control over the treatment of the disease.

All pregnant women are encouraged, in early pregnancy, to undergo preventive examination and get tested for syphilis.

If the disease is advanced, it is possible:

• severe heart disease;
• spinal injuries;
• blindness;
• disorders of brain activity;
• of death.

Testing for syphilis requires serious preparation.

You must tell your doctor:

• whether you are taking antibiotics or other medications;
• whether you are allergic to medications (antibiotics and anesthetics);
• whether you have problems with spontaneous bleeding;
• about your pregnancy status.

If you are diagnosed with syphilis, you must avoid sexual intercourse until you have completed the full course of treatment. Your sexual partner must also pass full examination.

A complete blood count for syphilis is usually performed within one week, however, modern equipment allowed to reduce these terms to one day.

Deciphering a general blood test for syphilis shows:

Most often in venereology, the term "serological blood test" is used.

This method is usually applied:

• when studying antigens or antibodies in blood serum;
• to establish a blood group;
• to determine the presence of antibodies to certain types of viruses and bacteria (syphilis, toxoplasmosis, hepatitis, chlamydia, measles, rubella, mumps, cytomegalovirus, herpes simplex, mycoplasmosis).

Modern diagnostics divides serological analysis into two groups:

• non-treponemal (non-specific) tests;
• treponemal (specific) tests.

Usually, four weeks after infection, a positive test for syphilis is detected.

If the analysis shows a positive result, then, obviously, the person is sick with this sexually transmitted disease.

A false positive test for syphilis occurs in about five percent of patients.

Possible reasons false positive analysis:

• systemic lesions connective tissue(scleroderma, dermatomyositis, rheumatoid arthritis, vasculitis, lupus erythematosus);
• infections (hepatitis, tuberculosis, mononucleosis, intestinal infections);
• inflammation of the heart (myocarditis, endocarditis);
• pregnancy;
• diabetes;
• recent vaccination;
• use of drugs, alcohol.

Reasons for possible false negative results:

• a large number of antibodies in the blood
• analysis taken before possible appearance antibodies;
• the analysis was taken with chronic syphilis (the amount of antibodies in the blood is significantly reduced).

A false (erroneous) analysis for syphilis can occur in about 10% of patients, but with repeated retakes of the analysis, this error will be noticed and corrected.

Note that every pregnant woman is tested for syphilis during pregnancy.

Moreover, she does this three times:

• upon registration;
• in the second trimester;
• in the third trimester.

With this order of testing, the disease can be detected in a timely manner.

The minimum price for testing for syphilis starts from 1,500 rubles.

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Blood tests for syphilis

The earlier and more accurately syphilis is detected, the easier treatment and there is a higher chance that it will go smoothly for the patient.

The goal for all laboratory tests is the same: to make a diagnosis unambiguously and quickly. But none of the modern high-tech tests for syphilis gives the result unambiguously and with 100% accuracy. Old methods are improved, new ones are invented, but until now, in clinical practice, doctors always have to use a combination of several different tests for syphilis. Physicians cannot rely on the result of any one.

There are so many varieties of analyzes for syphilis that it is impossible to understand all the abbreviations on the go:

For the first time, it was possible to identify the disease using a laboratory reaction in 1906. This is the merit of the German scientist August Wassermann, after whom the reaction is named. A lot of time has passed since then, the method is outdated and is not used in practice, but the diagnosis of syphilis is still strongly associated with the analysis of RV.

A person may need to be tested for syphilis for a variety of reasons. The very first reason that comes to mind is when an infection is suspected, and in practice it is not the most common. In this case, it is important to understand that the infection has incubation period(from the moment of infection to the formation of a hard chancre) and the primary seronegative period (hard chancre in the first three weeks) - at this time, the tests will be negative. Therefore, if the fears are serious, the tests are repeated in a few weeks.

People who do not suspect any infection are required to be tested for syphilis more often. This usually happens when applying for a job (the analysis is included in the medical book) and during periodic medical examinations (medical examinations). It is also mandatory to give blood for syphilis:

• donors
• women in the first weeks of pregnancy - twice, upon registration in women's consultation and in the hospital a few weeks before the birth,
• patients before surgery or any other medical invasive interventions (EGD, bronchoscopy, etc.).

At the end of the article, we answered the most FAQ people faced with the diagnosis of syphilis. No time to read details about research methods - scroll down.

All types of research on syphilis

There are 2 main groups of research methods for syphilis: direct and indirect.

• The direct method is a study in which the infection itself is searched for in the biomaterial - individual representatives of the pathogen as a whole, or their pieces - DNA.
• Indirect methods (serological reactions) are a study in which they try to detect antibodies to the causative agent of syphilis in the blood. The logic is as follows: if an immune response characteristic of some kind of infection is found, then there is the infection itself, which caused this immune response.

Direct methods are the most reliable: if the bacterium is "caught red-handed", then the presence of the disease is considered proven. But treponema pallidum is difficult to catch, and negative test results do not exclude the presence of infection. It makes sense to conduct these studies only in the presence of rashes and only in the early form of syphilis - up to two years of illness. Those. it is impossible to determine latent syphilis or its late forms by these methods, therefore, in clinical practice, they are rarely used and only to confirm other tests.

Direct methods include: Dark-field microscopy, Infection of laboratory animals, PCR.

1. Dark-field microscopy (TPM) - the study of pale treponema under a microscope. The material is taken from a hard chancre or rash. The method is cheap and fast, and detects syphilis at the very beginning of the primary period, when blood tests for syphilis are still negative. But bacteria, which are in small quantities in the rashes, can easily not get into the scraping. Plus, pale treponemas can be easily confused with other inhabitants of the oral cavity, anal canal, etc.
2. Infection of laboratory animals is a very expensive and painstaking method, used only in research practice.
3. PCR is a relatively new method, it looks for the DNA of an infection. Any tissue or liquid that may contain pale treponemas is suitable for research: blood, urine, prostate secretion, ejaculate, scrapings from skin rashes, from the genitourinary tract, oropharynx or conjunctiva. The analysis is very sensitive and specific. But complicated and expensive. Assign it in case of questionable results of other tests.

Indirect methods, they are also serological reactions, are the basis of the laboratory study of syphilis. It is these methods that are used for mass screening of the population, to confirm the diagnosis and control treatment. Indirect research methods are divided into non-treponemal and treponemal tests.

Non-treponemal tests are noticeably cheaper. For their implementation, not the antigen protein itself, specific for syphilitic treponema, is used, but its replacement, the cardiolipin antigen. These tests are highly sensitive but weakly specific. This means that such tests will identify anyone who has both syphilis and more: healthy people there may also be false positive results. They are used for mass screening of the population, but in the case of a positive result, they must be confirmed by more specific tests - treponemal. Still non-treponemal tests are very useful in evaluating the effectiveness of treatment: when effective treatment the volume of antibodies in the blood decreases, and their titer decreases accordingly (we will talk about these titers a little further in more detail). The most reliable result of these non-treponemal tests will be during early syphilis especially in the secondary period.

Non-treponemal tests include:

• The Wasserman reaction (RW, aka RV, or RSK) is already outdated and not used, but because of the strong association with the disease, any tests for screening the population for syphilis are often called so. If you see a record “PB analysis” in the direction from the doctor, don’t be embarrassed, the laboratory will surely understand everything correctly and will do RPR.
• The microprecipitation reaction (MR, aka RMP) is a simple and cheap test for the detection of syphilis. Previously used as the main non-treponemal test, but has now given way to a more convenient and objective RPR test.
• The Rapid PlasmaRegine Test (RPR-test) is a quick, simple and convenient test for mass screening of the population and monitoring treatment. It is the main non-treponemal test used in Russia and abroad.
• TRUST is a more modern modification of the RPR test. In another way, it is referred to as the RPR test with toludine red. In Russia, it is used only in a small number of laboratories.
• VDRL - this analysis is similar to RMP in terms of reliability of results, and is also inferior to RPR. In Russia, he did not find wide application.
• The USR test (or its modification - the RST test) is a more advanced VDRL test, but it is also rarely used in Russia.

Treponemal tests are performed with treponemal antigens. They are more specific, and therefore more carefully weed out the healthy from the sick. But their sensitivity is lower, and such tests can miss a sick person, especially at an early stage of the disease. Another feature is that treponemal tests appear later than non-treponemal ones, only three to four weeks after the appearance of a hard chancre. Therefore, they cannot be used as screening. The main purpose of treponemal tests is to confirm or refute the results of non-treponemal tests.

Still, the results of treponemal tests will remain positive for several years after successful treatment. Because of this, they are not used to monitor the effectiveness of treatment, and also do not rely on the results of these tests, unless they are confirmed by non-treponemal tests.

Treponemal tests include:

• RPHA (or its more modern modification - TPPA, TPNA) is a passive hemagglutination reaction. The main treponemal reaction currently used abroad and in Russia. A simple and convenient test for the detection of syphilis antibodies in the body.
• ELISA (anti-Tr. pallidum IgG / IgM) - enzyme immunoassay, also known as ELISA from the English abbreviation. This test can be performed with both cardiolipin antigen and treponemal. It can be used both for screening and as confirmation. In terms of reliability, it is not inferior to RPHA and is also the recommended treponemal test to confirm the diagnosis of syphilis.
• Immunoblotting is a more expensive advanced ELISA test. Used only in cases of doubt.
• RIF - immunofluorescence reaction. Technically difficult and expensive analysis. It is secondary, used to confirm the diagnosis in doubtful cases.
• RIBT (RIT) - reaction of immobilization (immobilization) of pale treponemas. This reaction is complex, lengthy in execution and difficult to interpret the result. In some places it is still used, but gradually fades into the background, giving way to RPHA and ELISA.

Deciphering serological tests for syphilis:

Algorithm for the diagnosis of "syphilis"

Any diagnosis consists of three main pillars of medicine: anamnesis (medical history), clinical manifestations(symptoms) and laboratory examination. If the doctor, according to the patient's story and external examination of his body, suspects syphilis, he prescribes a set of tests (or a set of serological reactions - CSR). It necessarily includes 1 non-treponemal test (RMP or RPR) and 1 treponemal test (TPHA or ELISA). If the results of these tests differ, an additional alternative treponemal test (ELISA or RPHA) is performed. This is the simplest scheme. In case of doubtful indicators, depending on the situation, the doctor prescribes other diagnostic methods.

Rapid test for syphilis, or how to determine syphilis at home

There is a test for syphilis that you can do yourself. It can be freely bought at a pharmacy, the average cost is 200–300 rubles. The principle of determining the disease is similar to non-treponemal RPR. Manufacturers claim high accuracy, but in reality it is low, no more than 70%.

The algorithm of actions during the test resembles a pregnancy test, only blood is used instead of urine. A drop of blood is applied to the indicator, and the result appears within 10-15 minutes. 1 strip - the test is negative, 2 strips - the test is positive. We do not recommend this diagnostic method. If you have any doubts about syphilis, it is better to immediately consult a doctor, or at least an independent laboratory. It will be a little more expensive and longer, but much more accurate.

Deciphering the results for syphilis: pluses, crosses and credits.

Further tactics of the doctor depend on the results of certain tests. The results of screening analyzes are expressed either in crosses (pluses) or in a separate entry:

4 or 3 crosses - a positive result, further examination for syphilis is necessary using other diagnostic methods. 2 or 1 cross - doubtful result, it is recommended to repeat the result after 10 days.

0 crosses - a negative result, syphilis was not detected.

In the case of a positive and doubtful reaction, additional research taken blood: diluting it from 1:2 to 1:1024 and adding a drop of cardiolipin antigen to each blood titer. The maximum titer at which the reaction occurred is recorded in the result: the greater the dilution, the greater the titer value, the higher the number of pale treponemas in the blood. But the main task of determining the titer is not to calculate the degree of blood contamination, but to control the success of the treatment: the treatment is considered effective if the titer drops by 4 times in 4 months. By the end of treatment, the results of non-treponemal tests should become negative.

The highest sensitivity of screening tests is observed in the secondary period of syphilis (100%), slightly less in the primary (86%) and even less - in the tertiary (73%).

Important nuances in the diagnosis of syphilis:

1. When conducting tests, false positive results are possible. They are especially common during screenings. If you have never had syphilis, and the tests are positive, you should not panic right away, you need to do at least one more alternative analysis.
2. There are also false negative results. If there is a suspicion of syphilis, then it is better to repeat the analysis after a few weeks.
3. Cured syphilis remains positive on treponemal tests for several years or a lifetime.

The most common questions about syphilis tests

How to get tested for syphilis for free?

To do this, you need to contact the clinic at the place of residence and visit your local doctor, who will give a referral for analysis. Testing for syphilis is free for all residents of the Russian Federation. compulsory medical insurance policy.

Where can I get tested for syphilis anonymously?

Anonymous tests can be taken at any paid laboratory, skin care clinics often offer this service themselves. Also, it is possible to test for syphilis at home using rapid tests that are sold in pharmacies. However, it must be remembered that such a test does not give an accurate result, and if you suspect syphilis, you should consult a doctor.

How many days after sexual intercourse can I donate blood for syphilis?

After 1-1.5 months. If an infection has occurred, then the test for syphilis will be positive no earlier than seven to ten days after the appearance of a hard chancre, or 4 to 5 weeks after infection. This period may be longer, so if the results are negative, the analysis should be repeated after 2 weeks.

Where do they take blood for syphilis?

Blood for syphilis is taken more often from a vein, but can also be taken from a finger. It depends on the type of analysis.

Training. How to get tested for syphilis?

Before donating blood for syphilis, you can not eat for four hours - blood must be donated on an empty stomach. In addition, 12 hours before the analysis, you can not drink alcohol. This is important because alcohol damage to the liver can cause false positive tests.

How long does an average test for syphilis take?

The results are usually available the next day. The rapid tests take no more than 30 minutes.

What analysis is taken for syphilis and what is it called?

For screening, when there is no suspicion of a disease, either RMP (microprecipitation reaction) or RPR (rapid plasma reagin test). Sometimes such screening tests are called the Wasserman reaction.

If there are any real suspicions or doubts, they are never limited to one analysis. At the same time, one of any of the screening group (RMP or RPR) and one of any of the more specific screening group (RPHA or ELISA) are performed, then they act depending on the results and the history of the patient.

Can a syphilis test be wrong?

Maybe! The probability of error of different methods depends primarily on the period of illness and the general condition of the body.

Non-treponemal tests are most sensitive at the height of the disease - in the secondary period. Due to their low specificity, they often give false positive results. This can happen due to fever, the flu or another infectious disease, a recent vaccination, chronic illness, and a number of other reasons.

Treponemal tests are more sensitive in the late period. They can also give false positive results, but only if there are pathogenic bacteria similar to pale treponema in the body that cause other diseases: non-venereal pint treponematoses (rare in Russia) or Lyme disease (transmitted through tick bites).

False-negative test results are possible with all diagnostic methods. They depend on the body's immune response: no response - no reaction to syphilis. This is possible in HIV-infected people, as well as immunocompromised for other reasons. In addition, there is a reverse reaction: hyperproduction of antibodies, the “prozone” effect, in which there are so many antibodies that they do not allow each other to react with the antigen. The result is a false negative result.

Can general tests show syphilis?

Syphilis cannot be determined either by a general blood test or a biochemical one. A general urine test or a regular vaginal smear will not show it either. All studies on syphilis are highly specialized and each has its own name. For any other analysis, it is impossible to calculate whether a person has syphilis or not. But what will other tests show if a person has syphilis? Let's analyze each of them:

Complete blood count: shows the main blood cells - erythrocytes, leukocytes, platelets. At the end of the primary and at the beginning of the secondary period, leukocytes may rise in a person, as well as an increase in ESR - an indicator of inflammation. These are very non-specific indicators, indicating simply that the body is fighting against bacterial infection. The rest of the blood test will correspond to the general condition of the body.

Biochemical blood test: shows the work of the liver, kidneys, heart, pancreas and other organs. If syphilis has not yet struck these organs, and they are working properly, the blood test will be normal.

Urinalysis: shows the work of the kidneys and the endocrine system, as well as the general condition of the body. If acute or chronic diseases these systems are not present - the analysis will be normal.

Vaginal swab: determines whether there is an inflammatory or oncological process, as well as dysbacteriosis. It is impossible to put syphilis on such a smear.

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What are the tests for syphilis, their decoding

An analysis for syphilis is done using many methods for detecting the pathogen. With the development of pathology, a large number of specific signs appear. In order to establish an accurate diagnosis, the patient is examined comprehensively. A general blood test is not very informative; it is not used in diagnosing a venereal infection.

Types of studies and biomaterials for analysis

Used to detect disease various methods and biomaterials. In the early stages, syphilis is determined using a bacterioscopic test. Samples are examined under a microscope. The device allows you to detect strains of the pathogen. Later, serological tests are carried out. Thanks to them, antigens and antibodies to the disease are detected in the samples.

Methods for determining sexual infection are divided into 2 categories:

• Direct, revealing a pathogenic microorganism. These include: dark-field microscopy, RIT analysis (infection of rabbits with biomaterial for research), the PCR method - polymerase chain reaction (with its help, the genetic elements of the pathogen are found).
• Indirect (serological) detection of antibodies to a pathogen. They are produced by the immune system in response to infection.

Serological methods are divided into 2 categories: treponemal and non-treponemal.

Non-treponemal, including: test with toluidine red, RSK analysis, RPR-test, blood test using the RMP express method.

Treponemal, combining: immunoblotting, RSK test, RIT analysis, RIF study, RPGA test, ELISA analysis.

Informativeness of tests for infection is different. More often do the main types of tests for syphilis, which include serological methods. For patients who need examination, the doctor prescribes tests individually.

Biomaterial for research

To identify pale treponema, a pathogen that looks like a spiral and causes syphilis, samples are taken:

• venous blood;
• liquor (secretion from the spinal canal);
• content lymph nodes;
• ulcer tissue.

If it is necessary to conduct tests for the detection of syphilis, blood is taken not only from the cubital vein, but also from the finger. The choice of biomaterial and the method of research is influenced by the severity of the infection and the equipment of the diagnostic center.

Direct Research

Convincing evidence of syphilis is the identification of infectious agents under a microscope. In this way, the pathogen is found in 8 out of 10 examined patients. A negative result in the remaining 2 patients does not mean that they are not infected.

The study is done at the primary and secondary stages (stages) of the disease, which are characterized by the appearance of rashes on the skin and syphilomas (ulcerations) on epithelial tissues or mucous membranes. In the discharge from the lesions, pathogens that cause a venereal disease are found.

More precisely, a complex test, referred to as RIF, an immunofluorescence reaction, copes with the determination of treponema. The sample for research is pre-treated with fluorescent antibodies. Compounds capable of glowing stick together with bacteria. Examining samples under a microscope, in case of infection, the laboratory assistant sees sparkling pathogens.

The test is used for early diagnosis of the disease. The longer the disease lasts, the lower the sensitivity of research methods. In addition, it falls after the treatment of rashes and ulcers. antiseptics and in treated patients. Occasionally, the study gives false-negative and false-positive results.

RIT analysis is a highly accurate way to detect syphilis. During the test, the results take a long time to wait. Until the infected rabbit shows signs of infection. The test is used very rarely, despite the fact that it is extremely accurate.

Using the polymerase chain reaction for syphilis, the genetic elements of pathogens are determined. The only drawback of PCR is the high cost.

Non-treponemal tests

These blood tests help detect antibodies that appear in response to cardiolipin, a compound related to general structure pathogen membranes.

Wasserman reaction (РВ or RW)

The most famous test for syphilis is the Wasserman reaction. RS is included in the category of complement fixation reactions (CFRs). The new RSC methods have significant differences from the traditional RW. But they are designated, as before, by the concept of "Wasserman reaction".

The immune system, synthesizes antibodies (markers) in response to treponema invasion. They are detected in a blood test for syphilis by the Wasserman reaction method. A positive RW result confirms the infection of the subject.

Hemolysis reaction - PB analysis index. With it, 2 substances interact: hemolytic serum and sheep erythrocytes. Serum is made by immunizing a rabbit with ram erythrocytes. The activity of the biological fluid is reduced by heating.

RV indicators depend on whether hemolysis has passed or not. In a sample free of markers, hemolysis occurs. In this case, the reaction to antigens is impossible. Complement is spent on interaction with sheep erythrocytes. When there are markers in the sample, the compliment reacts with the antigens. In this case, hemolysis does not occur.

Components for RW are measured in equal quantities. The sample containing serum, antigen and compliment is warmed up. Sheep erythrocytes and serum are added to the sample. Keep at a temperature of 37 degrees until hemolysis occurs in the control sample, which instead of the antigen contains saline.

For conducting RV, ready-made antigens are used. The titers and the technology of their dilution are indicated on the packages. A positive RW result is indicated by crosses. Ready test results are indicated as follows:

• ++++ - maximally positive (hemolysis delayed);
• +++ - positive (hemolysis is significantly delayed);
• ++ - weakly positive (hemolysis partially delayed);
• + - doubtful (hemolysis was slightly late).

With a negative RV, hemolysis was completely realized in all samples. But in some cases, false positive data are obtained. This happens when cardiolipin is part of the cells. Protective mechanisms do not produce markers for "native" cardiolipin.

However, there are rare exceptions. Positive RW is detected in uninfected people. This is possible if the patient has suffered a serious illness caused by viruses (pneumonia, malaria, tuberculosis, liver and blood pathologies). Positive RV occurs in pregnant women. This is due to the fact that the immune system is excessively weakened.

If there is a suspicion that the test result for syphilis is false positive, the patient is examined additionally. The problem is that this infection cannot be detected by a single clinical laboratory test. Some studies give false indicators, which are both negative and positive.

A detailed analysis for syphilis helps to obtain reliable data. Thanks to him, a true diagnosis is established: they prove infection or exclude it. In addition, an extended test allows you to stop the development of infection, to exclude unnecessary therapy.

RSK and RMP

When conducting a survey for syphilis, the traditional Wasserman reaction is used extremely rarely. Instead, the RSC method is used. The test gives a positive result 2 months after infection. In the secondary form of the disease, it is positive in almost 100% of cases.

The method of microprecipitation (RMP) is a study with a mechanism similar to the Wasserman reaction. The technique is simple to perform. It is carried out quickly. For research, blood for syphilis in this case is taken from a finger. The technique gives a positive result 30 days after the onset of syphilomas. Errors in the study are not excluded. False-positive data are obtained against the background of: exacerbated infections, pneumonia, heart attack, stroke, intoxication.

Leads to erroneous tests:

• tuberculosis;
• Besnier-Beck-Schaumann disease;
• rheumatoid diseases;
• diabetes;
• cirrhosis;
• brucellosis;
• leptospirosis;
• mononucleosis.

Discovering dubious analysis for syphilis, do treponemal studies. They help clarify the diagnosis.

RPR and toluidine red test

The plasma reagin method (RPR) is another analogue of the Wasserman reaction. It is used when necessary:

• screen asymptomatic individuals;
• confirm syphilis;
• examine donated blood.

The toluidine red test, like the RPR, is performed to assess the progress of drug therapy. Their indicators fall when the disease recedes, and increase when the pathology recurs.

Non-treponemal tests show how much the patient has recovered. Obtaining negative results for syphilis indicates that the disease has receded completely. The first examination is done 3 months after course therapy.

Treponemal studies

High performance assays are performed using treponemal antigens. They are made when:

• a positive result was obtained with the RMP method;
• it is necessary to recognize erroneous data arising from screening tests;
• suspect the development of syphilis;
• it is necessary to diagnose a latent infection;
• a retrospective diagnosis should be made.

RIF and RIT tests

In many treated patients, treponemal testing of samples gives positive results for a long time. They can not judge the degree of effectiveness of treatment. RIT and RIF are supersensitive tests. They provide reliable data. These analyzes are time-consuming, they require a decent amount of time, the availability of advanced equipment. They can be carried out by qualified medical personnel.

Performing a RIF analysis for syphilis, positive data are obtained 2 months after infection. Negative parameters confirm that the subject is healthy. Positive - suggest that the person is infected.

RIT is carried out when the microprecipitation reaction is positive. Such a blood test for syphilis helps to refute or certify the presence of an infection. The test is ultra-sensitive, it accurately indicates whether a patient is infected or healthy. But the study provides reliable data only 3 months after the penetration of treponema into the body.

Western blotting method

Ultra-precise tests include immunoblotting. Such a blood test for syphilis is rarely done. It is used in the examination of newborns. It is not suitable for express testing. Positive results received late. They are much earlier given by the microprecipitation method.

ELISA and RPHA

Informative ultra-precise research methods include ELISA and RPHA tests. They are used for rapid diagnosis. Laboratory assistants do a huge number of such analyzes. Thanks to them, it is possible to establish an accurate diagnosis.

RPHA analysis for syphilis is positive 30 days after the pathogen enters the body. With its help, a primary infection is diagnosed when ulcers and a rash appear.

Thanks to him, it is possible to identify neglected, secretly current, as well as congenital forms of pathology. But it is carried out in conjunction with non-treponemal and treponemal tests. Comprehensive diagnostics guarantees the reliability of the results. Triple testing accurately proves the presence or absence of a venereal infection.

positive reaction persists over a long period of time. For this reason, the study is not used to evaluate the effectiveness of treatment.

ELISA analysis is positive 21 days after infection. The test sometimes gives erroneous results. They appear with systemic pathologies, impaired metabolic processes. Their effectiveness is questionable in a child born to an infected mother.

The errors obtained with serological methods of research have become the reason for the discovery of progressive diagnostic methods. Gas chromatography and mass spectrometry do not give false results. The only obstacle to their mass use is the high cost.

Diagnosis algorithm

• When syphilis is in the primary phase (up to 60 days from the moment of infection), the pathogen is searched for on a dark background or fluorescent antibodies are used to detect them.
• If the pathology is in the primary, secondary or latent form, RMP and ELISA are used. A RPGA blood test for syphilis helps confirm the results.
• In case of recurrence of a secondary infection, the discharge of ulcers and rashes is analyzed. Pathogens are removed from the samples, they are studied using microscopy.
• When the disease enters the tertiary phase, 1/3 of patients have a negative bladder cancer. At the same time, the results of ELISA and RPHA are positive. However, they do not always indicate the tertiary period, but confirm that the person has had an infection earlier. A weakly positive test is evidence of a complete cure, and not the development of a tertiary phase.
• Confirming congenital syphilis, a blood test is taken from the mother and baby. Compare the data of RMP tests. Take into account that the baby's ELISA and RPHA are positive. Confirm the diagnosis using immunoblotting technique.

Syphilis, like any systemic pathology, affects the entire body. Therefore, examinations for it are carried out during pregnancy, before an abortion. Patients do RMP, ELISA, RPHA.

How to take an analysis

A venereologist sends patients for analysis. Private laboratories do anonymous research on syphilis at the request of the client. They do not require a doctor's referral to take the test.

Research rules:

• Blood in the laboratory is taken in the morning on an empty stomach (eat after the procedure). Before the analysis it is allowed to drink only water.
• 2 days before the examination, it is forbidden to eat fatty foods and drink alcohol.
• Blood is taken from a finger or vein.
• How long does the study take? Usually no more than a day. A transcript of tests for syphilis is obtained from laboratory assistants or the attending physician.
• How long is the test valid? After 3 months, the test results become invalid. They are being sold again.

If the transcript of the analysis shows that the test is positive, you need to visit a venereologist who will prescribe additional examination to accurately confirm the diagnosis and select the appropriate treatment regimen.

Spinal content testing

The diagnosis of neurosyphilis is made after examining the cerebrospinal fluid. This analysis is done:

• people with a latent form of infection;
• with disease symptoms nervous system;
• asymptomatic, advanced neurosyphilis;
• recovered patients with positive serological tests.

The direction for the study of cerebrospinal fluid is given by the doctor. From the spinal canal take a puncture in 2 test tubes. The puncture is smeared with iodine, covered with a sterile napkin. After the procedure, the patient is on bed rest for 2 days.

In 1 sample, the amount of protein, cells, traces of meningitis is determined. In the second sample, antibodies to the causative agent of syphilis are calculated. For this, tests are made: RV, RMP, RIF and RIBT.

Depending on how many violations are detected, 4 types of liquor are distinguished. Each indicates certain damage to the nervous system. The doctor diagnoses:

• vascular neurosyphilis;
• syphilitic meningitis;
• dorsal dryness and so on.

In addition, the results of the tests judge the recovery of the patient.

The interpretation of tests is the doctor's task. Only he is able to draw the right conclusions, if necessary, prescribe an additional examination, and make an accurate diagnosis. It is not necessary to make an independent diagnosis in case of a dangerous systemic pathology. Misdiagnosis has serious consequences.

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