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Syphilis Tests Results
Hello! I am pregnant and as part of antenatal care was tested for syphilis. The following tests were done with the results:
TPPA - positive 1>80
Mercia EIA for T.Pallidum IqM - negative
T.Pallidum Abbot Architect - positive
RPR - negative
The report for the tests was "consistent with treponemal infection at some time" I've never had any symptoms of syphilis, was never treated for syphilis (though received some heavy antibiotic treatment for chronic pielonephrytis 6 and 10 years ago) and my partner's tests are all negative. I have been with the same and only partner for 3 years.
What could be other possible explanations for those results? Is there any danger for the baby to be infected? I got 3 shots of b.penicillin IM over three weeks but I was already 35 weeks pregnant.
Thank you very much for your help!
TPPA - positive 1>80
Mercia EIA for T.Pallidum IqM - negative
T.Pallidum Abbot Architect - positive
RPR - negative
The report for the tests was "consistent with treponemal infection at some time" I've never had any symptoms of syphilis, was never treated for syphilis (though received some heavy antibiotic treatment for chronic pielonephrytis 6 and 10 years ago) and my partner's tests are all negative. I have been with the same and only partner for 3 years.
What could be other possible explanations for those results? Is there any danger for the baby to be infected? I got 3 shots of b.penicillin IM over three weeks but I was already 35 weeks pregnant.
Thank you very much for your help!
MEDICAL PROFESSIONAL
Hi Yasira,
Syphilis is very common indeed in Russia and the former Soviet Union so it is possible you mya have been infected many years ago.
The EIA is an IgM. This is unusual to be reported alone. Uusually we would expect an IgG and IgM. IgM indicates very recent infection or reinfection. Its absence means your infection is old.
Congenital syphilis is unlikely because:-
1) You don't seem to have an active infection but an old one
2) the chances of congenital syphilis in an infant where the mother does not have active infection is unlikely. This usually follows an active infection, which you seem not to have.
best regards, Sean
Syphilis is very common indeed in Russia and the former Soviet Union so it is possible you mya have been infected many years ago.
The EIA is an IgM. This is unusual to be reported alone. Uusually we would expect an IgG and IgM. IgM indicates very recent infection or reinfection. Its absence means your infection is old.
Congenital syphilis is unlikely because:-
1) You don't seem to have an active infection but an old one
2) the chances of congenital syphilis in an infant where the mother does not have active infection is unlikely. This usually follows an active infection, which you seem not to have.
best regards, Sean
Hi Sean,
Thank you very much for your post.
I am certainly going to have a deep discussion with a doctor specialising in STDs after the delivery as I am due next week. I will also have tests done again when I am not pregnant. My obstetrician recommended this as well as they didn't seem to know much themselves. They hadn't had positive syphilis results for years I was told. Which doesn't surprise me as I live in the country in Ireland where syphilis is quite uncommon. I immigrated to Ireland from Russia 7 years ago.So Yaws and Pinta can definitely be excluded as I've never even been to South America, Africa or Asia.
Meanwhile, I am asking questions here because I am sick worrying about the baby.
What would you possible opinion based on the test results above be, Sean?
What confuses me most is negative EIA. As far as I know it's a terponemal test as well and it's considered to be quite reliable. Why is it negative while the other two are positive? Does negative RPR mean that infection's not active?
And the main concern: are the chances for the baby to be born with congenial syphilis high? My obstetrician says they are not but I was in a state of a complete shock after learning the news so maybe it was said to calm me down?
Your opinion is really appreciated. Thanks again.
Thank you very much for your post.
I am certainly going to have a deep discussion with a doctor specialising in STDs after the delivery as I am due next week. I will also have tests done again when I am not pregnant. My obstetrician recommended this as well as they didn't seem to know much themselves. They hadn't had positive syphilis results for years I was told. Which doesn't surprise me as I live in the country in Ireland where syphilis is quite uncommon. I immigrated to Ireland from Russia 7 years ago.So Yaws and Pinta can definitely be excluded as I've never even been to South America, Africa or Asia.
Meanwhile, I am asking questions here because I am sick worrying about the baby.
What would you possible opinion based on the test results above be, Sean?
What confuses me most is negative EIA. As far as I know it's a terponemal test as well and it's considered to be quite reliable. Why is it negative while the other two are positive? Does negative RPR mean that infection's not active?
And the main concern: are the chances for the baby to be born with congenial syphilis high? My obstetrician says they are not but I was in a state of a complete shock after learning the news so maybe it was said to calm me down?
Your opinion is really appreciated. Thanks again.
MEDICAL PROFESSIONAL
Hi Yasira,
I agree with Sol. This is something you need to discuss in detail with your physician/Obs and Gynae docors.
Positive syphilis tests do not necessarily mean previous infection with syphilis. Syphilis is caused by a group of organsims called treponemes which also cause illnesses such as Yaws and Pinta . If you hva elived in areas where these conditions are endemic then there is a possibility that rather than syphilis, Yaws or Pinta may have caused the test abnormalities. These areas are South America, Africa and Asia.
Your tests showed:-
TPPA - positive 1>80
Mercia EIA for T.Pallidum IqM - negative
T.Pallidum Abbot Architect - positive
RPR - negative
The TPPA is a specific treponemal test (note not a specific syphilis test). The test was positive.
The Abbott test was positive and in tests run by the UK Health Protection Agency has been shown to be a very accurate test for syphilis itself.
The RPR was negative.
The great difficulty is that with your sort of results we are often unable to identify where there was true syphilis or Yaws or Pinta. In which case we err on the side of great caution and treat as though syphylis was the main infection. Your doctors have done this, partly because that represents best practice anyway and partly because of the pregnancy.
Again, as with Sol's advice, I would have a further in depth discussion with your physicians.
best wishes, Sean
I agree with Sol. This is something you need to discuss in detail with your physician/Obs and Gynae docors.
Positive syphilis tests do not necessarily mean previous infection with syphilis. Syphilis is caused by a group of organsims called treponemes which also cause illnesses such as Yaws and Pinta . If you hva elived in areas where these conditions are endemic then there is a possibility that rather than syphilis, Yaws or Pinta may have caused the test abnormalities. These areas are South America, Africa and Asia.
Your tests showed:-
TPPA - positive 1>80
Mercia EIA for T.Pallidum IqM - negative
T.Pallidum Abbot Architect - positive
RPR - negative
The TPPA is a specific treponemal test (note not a specific syphilis test). The test was positive.
The Abbott test was positive and in tests run by the UK Health Protection Agency has been shown to be a very accurate test for syphilis itself.
The RPR was negative.
The great difficulty is that with your sort of results we are often unable to identify where there was true syphilis or Yaws or Pinta. In which case we err on the side of great caution and treat as though syphylis was the main infection. Your doctors have done this, partly because that represents best practice anyway and partly because of the pregnancy.
Again, as with Sol's advice, I would have a further in depth discussion with your physicians.
best wishes, Sean
Hi,
This is something you need to discuss with your doctor especially since you are pregnant.
Sol
This is something you need to discuss with your doctor especially since you are pregnant.
Sol
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Syphilis is an STD that is transmitted by oral, genital and anal sex.
