Laboratory Diagnosis of Syphilis
2011
Dark field microscopy (DFM) is the only test that allows immediate diagnosis, treatment, and partner notification, thereby preventing further transmission. A highly positive IgM titer indicates, independently from the value of IgG or TPHA titer, an active infection and the need for treatment. A low IgM titer, in combination with a high IgG or TPHA titer, is consistent with a latent or chronic treponemal infection. A negative IgM test, in combination with a high positive IgG or TPHA titer and a positive nontreponemal test, is consistent with an active infection as well.
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