Syphilis, Wass - RPR, TPHA

General information:

Rapid plasma reagin (RPR) is a screening test for the presence of antibodies in the serum of a patient with suspected infection with Treponema pallidum (syphilis). This is one of the main non-treponemal tests. It should be noted that the negative result reflects the state of the organism at the time of the test, antibodies may not be detected weeks after contact with the disease. This necessitates repeated testing of those at high risk. With adequate treatment, the RPR test remains negative for up to 3 years. Therefore, its values are a marker for active /untreated/, reinfection or past infection /low titer/.
Treponema pallidum hemagglutination assay (TPHA,TPPA) is a test for detection and titration (during treatment) of the causative agent of syphilis. This is a specific treponemal test indicating infection, confirming after RPR. Remains positive years after syphilis treatment.
Syphilis is a sexually transmitted disease caused by the spirochete Treponema pallidum. It is also called "The Great Imitator" because it presents with many different symptoms that often resemble those of other diseases. Infection takes place when the bacteria get on a mucous membrane or through injured skin. The main way of transmission is sexual - through oral, anal, vaginal intercourse. There is congenital syphilis from a sick mother to the fetus during the period of pregnancy. Too rarely, other ways of infection are also possible: common accessories, blood products.
The disease progresses through several stages. The incubation period is 26 days on average.
The first symptom of primary syphilis is usually a small, round, hard sore, called a hard chancre, at the site of entry of the bacteria into the body. It usually appears on the penis, vulva, or vagina, but it can also appear on the neck, tongue, lips, or other parts of the body. Generally, there is only one hard chancre, but it is possible to have two or more. Adjacent lymph nodes are often enlarged. Hard chancre appears between 9 and 90 days after infection (average 21 days).
A hard chancre is usually painless, may appear inside the body, and disappears in about 3 to 6 weeks even without treatment. For these reasons, primary syphilis may not be detected and treated, and the infection may progress to the next phase.
Secondary syphilis - systemic phase of infection with the pale spirochete. Secondary syphilis usually manifests itself as a non-itchy skin rash - rough, red or red-brown spots. The rash breaks out most often on the palms of the hands and the soles of the feet, but it can be spread over the whole body or only in certain areas. The symptoms can be differently expressed - from mild to very severe. The sores of secondary syphilis contain a lot of bacteria and are highly contagious!!!
Other symptoms experienced by patients are: fatigue, headache, enlarged lymph nodes, sore throat, weight loss, joint pain.
The latent (hidden) phase of syphilis begins when the symptoms of secondary syphilis go away.
Early latent syphilis is characterized by mild or absent symptoms. At this stage of the disease, the carrier can still transmit the infection to his sexual partner.
During late latent syphilis, the infection is suppressed and the risk of infecting the sexual partner is very low or absent. However, if latent syphilis is not treated, the disease progresses to the most serious phase of the disease - tertiary syphilis.
Tertiary syphilis (Neuro syphilis) - in this phase, the bacteria damage various parts of the body, the heart, eyes, brain, nervous system, bones, joints, etc. These severe complications develop over years and even decades after the phase of primary syphilis. The so-called gummy lesions (syphilitic gums) are characteristic. Their size reaches the size of an egg, and the skin above them looks normal and the lesions are movable compared to the surrounding tissues. Over time, they grow, form a fistula, from which pus and blood material flows.
Late-onset syphilis leads to mental retardation, blindness, deafness, memory loss and other neurological problems, heart damage, and death. Late neurosyphilis (brain or spinal cord damage) is one of the most severe signs of this phase.
Screening for syphilis is carried out in the following cases:

• in case of suspicion or treatment for another sexually transmitted disease
• pregnancy (first, third trimester)
• patients with more than one partner in the last 6 months
• HIV patients
• patients were in contact with syphilis patients or their materials (blood)

Prevention of syphilis is achieved through regular examinations, monogamous and long-term relationships in which both partners have had a test for syphilis. The use of condoms protects only if the entire mucosa is covered and not in all cases. Important!!! Regular examinations and treatment of sores in the early stage of syphilis are an important preventive method for the disease.

Sample required:

Venous blood in morning in fasting

Key words:

Syphilis, Wass, RPR, TPHA