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Clinical management | How to Interpret Syphilis Test Results

Interpreting syphilis test results can be difficult, particularly if previous test results and treatment histories are unknown. A key role of the population/public health unit (PHU), some sexual health clinics and staff from syphilis registers in some regions is to assist with the accurate interpretation of syphilis serology.

Questions about test results can also be directed to the Specialist Microbiologist (a pathologist) responsible for authorising the laboratory test results or a sexual health physician, or infectious diseases physician, if available.

The following information is required to interpret syphilis test results for the purpose of diagnosing and staging syphilis:

  • Sexual history, symptoms and clinical signs AND
  • Treponemal test result AND
  • Rapid Plasma Reagin (RPR) test result AND
  • Previous syphilis serology results (if available) AND
  • History of treatment (if available).

RPR Interpretation:

(De-identified cases have been provided below for training purposes)


1Miller P, Skov S, Knox J. How to Interpret Syphilis Results: a Manual for Nursing and Medical Staff in Remote Communities. 2nd edn. Nganampa Health Council Inc., 1999. Available from: