Syphilis Screening: Traditional vs. Reverse Algorithms, False Positives, and the SLE Connection
Syphilis Screening: Traditional vs. Reverse Algorithms, False Positives, and the SLE Connection Two tests, two algorithms, one disease that's surging back—and the autoimmune pitfall that keeps tripping everyone up. Syphilis is back. Rates in the US have been climbing steadily, congenital syphilis cases have skyrocketed, and the CDC has made this a public health priority. For NPs in primary care, prenatal care, and urgent care, understanding the screening algorithms isn't optional anymore—it's essential. And the fact that your lab may be using a different algorithm than the one you learned in school makes it even more critical to know what you're looking at. The Two Categories of Tests Before we get to algorithms, you need to understand the two fundamentally different types of syphilis tests: Nontreponemal Tests (RPR, VDRL) Detect antibodies to cardiolipin-cholesterol-lecithin antigens released from damaged host cells and from T. pallidum itself NOT specifi...