False Positive “Confirmation” Syphilis Test?

There’s no such thing as a “false positive syphilis confirmation test”, is there? After all… It’s right there in the name, CONFIRMATION test! Well, not all positive confirmation tests are true positives, especially when that test is the FTA-ABS. Yes, it’s true, the specificity for this is very good between 95 to 98%. But there are cases of BFPs (Biologic False Positives), which have been reported and published in the literature. This is why putting the test results in clinical context is very important. In this episode, we will highlight a real clinical scenario where a “low level“ confirmation test did not fit the clinical picture (asymptomatic, monogamous, low risk patient). Is there something else going on here? What about autoimmune conditions? Can pregnancy itself cause a false positive FTA-ABS? And more importantly… What are the options for management in this case? We’ll discuss all of this, and also review the “reverse syphilis algorithm” in this episode.