Syphilis Test – Why am I having this test?

The syphilis test is used to diagnose syphilis and to help monitor syphilis treatment. Syphilis is a bacterial infection that commonly spreads through sexual contact. Syphilis may also spread to an unborn baby (fetus) through the blood of the mother.

You may have this test if you have symptoms of syphilis, such as a painless sore (chancre). Symptoms often look like the symptoms of many other conditions. As syphilis gets worse, early symptoms may go away before new symptoms develop. Untreated syphilis (late-stage syphilis) can lead to severe complications, including damage to the heart, brain, and nervous system.

Pregnant women often have a syphilis test. You may also have this test if you are at risk for syphilis because of:

• Having a sexual partner with syphilis.
• Engaging in high-risk sexual activity.
• Having another STI (sexually transmitted infection), such as gonorrhea.

What is being tested?

This test checks your blood for antibodies to the bacteria that cause syphilis. Antibodies are proteins that your body makes in response to germs and other things that can make you sick.

There are two types of blood tests to check for syphilis. Both tests are necessary to make a diagnosis:

• Nontreponemal test. This is usually the first test. It can detect other kinds of antibodies as well and may result in a positive result for syphilis even if you do not have the condition (false positive).
• Treponemal test. This test is done if you get a positive result to the nontreponemal test. It tests specifically for antibodies to syphilis. Other conditions are not likely to cause a false positive. This test will not show whether antibodies are from a past syphilis infection or a current infection.

What kind of sample is taken?

A blood sample is required for this test. It is usually collected by inserting a needle into a blood vessel.

If your health care provider thinks that you may have late-stage syphilis, you may have a lumbar puncture. This is a procedure in which a small sample of the fluid that surrounds the brain and spinal cord (cerebrospinal fluid or CSF) is removed to be examined for syphilis.

How do I prepare for this test?

• Do not eat or drink anything other than water starting 8 hours before the test, or as told by your health care provider.
• Do not drink alcohol starting 24 hours before the test.
• Tell a health care provider about any medical conditions you have.

How are the results reported?

Your results will be reported as positive or negative for syphilis antibodies.

What do the results mean?

If the result of your syphilis test is negative, no antibodies were present at the time of the test. This could mean:

• You do not have syphilis.
• The antibodies have not formed yet. Antibodies can take several weeks to form. If it is possible that you were recently exposed to syphilis, you may need to have the test again at a later time.

If you test positive for syphilis on the first nontreponemal test, you will most likely have the second treponemal test to confirm the diagnosis. If the result of the second test is also positive, it is likely that you have syphilis. If the result of the second test is negative, you may need more tests to make sure that you do not have syphilis.

Talk with your health care provider about what your results mean.

Questions to ask your health care provider

Ask your health care provider, or the department that is doing the test:

• When will my results be ready?
• How will I get my results?
• What are my treatment options?
• What other tests do I need?
• What are my next steps?

Summary

• The syphilis test is used to diagnose syphilis and to help monitor syphilis treatment. This test checks your blood for antibodies to the bacteria that cause syphilis.
• There are two types of blood tests to check for syphilis. Both tests are necessary to make a diagnosis.
• Talk with your health care provider about what your results mean.