Syphilis (RPR)

Syphilis is a bacterial STI caused by Treponema pallidum. It can be silent or present with a painless sore (chancre), a body rash, or vague symptoms, and—without treatment—may lead to serious heart, brain, and nerve problems. Testing is the safest way to know your status and protect partners.

Modern labs use a two-step approach: a nontreponemal screen (most often RPR) and a treponemal confirmatory test. Some labs use a reverse sequence (treponemal screen first, then RPR for titers). Your RPR titer helps estimate disease activity and is used to monitor treatment response. Testing supports screeningdiagnosis, and follow-up, but it does not replace clinician care, partner management, or emergency services.

Signs, Symptoms & Related Situations

  • Often no symptoms (screening still recommended based on risk)

  • Primary syphilis: single, firm painless sore at the site of exposure; local swollen nodes

  • Secondary syphilis: rash (often on palms/soles), fever, sore throat, patchy hair loss, mucous patches, condylomata lata

  • Latent syphilis: no symptoms; positive blood tests

  • Neurologic/ocular/otologic (any stage): headache, vision or hearing changes, stroke-like symptoms—urgent evaluation

  • When to test: new partner, condom break, partner positive, pregnancy or planning pregnancy, HIV or other STI risks

  • Seek urgent care now: severe headache, vision loss, hearing loss, confusion, neck stiffness, or pregnancy with concerning symptoms

All symptoms and risks should be reviewed by a qualified clinician.

Why These Tests Matter

What testing can do

  • Detect syphilis early and confirm with a second method

  • Provide a baseline RPR titer to help stage disease and monitor response after treatment

  • Support partner notification and follow-up to reduce reinfection

What testing cannot do

  • Pinpoint the exact date or location of infection

  • Replace evaluation for neurosyphilis/ocular syphilis (may need CSF testing and specialized exams)

  • Guarantee detection immediately after exposure—there is a window period; retesting may be needed

  • Provide treatment or dosing guidance—review results with your clinician

What These Tests Measure (at a glance)

  • RPR (Rapid Plasma Reagin): nontreponemal screen reported as reactive/nonreactive and, when reactive, a quantitative titer (e.g., 1:32). Titers trend down after effective treatment; rising titers suggest reinfection or treatment failure.

  • VDRL: alternative nontreponemal test; also used on CSF for neurosyphilis (clinician-directed).

  • Treponemal confirmatory tests: TP-PAtreponemal EIA/CIA, or FTA-ABS confirm infection (current or past). Treponemal tests often remain reactive for life.

  • Reverse sequence algorithm (common in many labs): treponemal screen first → RPR for activity/titer → if discordant, second treponemal test to resolve.

  • Window period: RPR/treponemal tests typically become positive ~3–6 weeks after exposure (or ~1–2 weeks after a chancre). If testing very early is negative but suspicion is high, retest in 2–4 weeks.

  • Special notes: Rare prozone effect can cause a false-negative RPR at very high antibody levels; labs can perform dilution if the clinical picture is strong.

Quick Build Guide

Goal / Scenario Start with Add if needed
Routine screen (no symptoms) RPR with treponemal confirm (or treponemal screen with reflex RPR) HIV • Hep B • Hep C • GC/CT NAAT
Recent exposure or chancre/rash RPR + treponemal confirm Retest in 2–4 weeks if early; broader STI panel
Pregnancy / prenatal care RPR with treponemal confirm Repeat later in pregnancy if risk; use quant RPR for follow-up
Test-of-cure / monitoring Quantitative RPR titer Trend at clinician-directed intervals
Neurologic/ocular symptoms Serologic testing (RPR + treponemal) Clinician-directed CSF VDRL and specialty exams
Partner positive RPR with treponemal confirm HIV • Hep B • Hep C • GC/CT NAAT and retesting per window periods

How the Testing Process Works

  1. Order the right algorithm: RPR with reflex treponemal confirm or treponemal screen with reflex RPR titer.

  2. Provide a sample: standard blood draw; no fasting required.

  3. Review secure results: most post within a few days; positives often reflex to confirmation automatically.

  4. Plan next steps: your clinician uses stage, symptoms, and titers to guide care and timing of follow-up testing.

  5. Retest if needed: early negative tests after recent exposure may need repeat testing.

Interpreting Results (General Guidance)

  • RPR reactive + treponemal reactive: consistent with syphilis (current or past). Use quantitative RPR titer as a baseline and for follow-up.

  • RPR reactive + treponemal nonreactive: possible biologic false positive or very early infection—repeat and consider a second treponemal test per algorithm.

  • Treponemal reactive + RPR nonreactive (reverse sequence): could reflect past treated infection or early infection before RPR rises—confirm with a second treponemal test and review history.

  • Fourfold change in RPR titer (e.g., 1:32 → 1:8) is typically considered clinically significant when monitoring.

  • Suspected prozone effect: ask the lab to repeat with dilutions if clinical suspicion is high.
    Always interpret results with a qualified healthcare professional; timing, symptoms, and titers matter.

Choosing Panels vs. Individual Tests

  • Core syphilis workflow: RPR (qual + quantitative) with reflex treponemal confirm or treponemal screen with reflex RPR

  • Expanded sexual health: add HIV 4th-genhepatitis B/Cchlamydia/gonorrhea NAAT, ± trichomonas

  • Neurologic/ocular cases (clinician-directed): consider CSF VDRL and specialty evaluations
    Use bundled panels for comprehensive screening; add targeted tests for symptoms, exposure sites, or monitoring.

FAQs

Do I need to fast for syphilis testing?
No. Syphilis blood tests do not require fasting.

What is the difference between RPR and treponemal tests?
RPR tracks disease activity and treatment response (titers). Treponemal tests confirm infection and often stay positive for life.

How soon after sex can I test?
Many infections are detectable by 3–6 weeks after exposure. If you test earlier and it’s negative, retest in 2–4 weeks.

Will I always test positive after treatment?
Treponemal tests often remain reactive. RPR may fall and sometimes become nonreactive over time.

How is cure checked?
Clinicians follow the quantitative RPR titer. A fourfold decline over time is a typical sign of response.

If my partner tested positive, what should I do?
Test now, consider a full STI panel, and retest at the recommended window periods.

I have eye or neurologic symptoms—will a blood test suffice?
Blood tests are a start, but suspected ocular/neurosyphilis needs urgent specialist evaluation and may require CSF testing.

Related Categories & Key Tests

  • STD Tests Hub

  • All STD Tests • HIV and AIDS Tests • Chlamydia Tests • Gonorrhea Tests • Hepatitis Screening Tests • Reproductive Health Tests

  • Key Tests: RPR (qualitative + quantitative titer) • Treponemal EIA/CIA • TP-PA • FTA-ABS (select use) • VDRL (serum/CSF—clinician-directed) • HIV-1/2 4th-Generation Ag/Ab • Hepatitis B Surface Antigen • Hepatitis C Antibody • Chlamydia/Gonorrhea NAAT

References

  • Centers for Disease Control and Prevention — Sexually Transmitted Infections Treatment Guidelines: Syphilis.
  • U.S. Preventive Services Task Force — Screening for Syphilis Infection.
  • World Health Organization — Syphilis testing and screening guidance.
  • Infectious Diseases Society of America — Diagnostic testing algorithms for syphilis.
  • American College of Obstetricians and Gynecologists — Syphilis screening in pregnancy.
  • Clinical reviews on reverse sequence algorithms, RPR titer interpretation, and prozone effect.

Available Tests & Panels

Your Syphilis (RPR) Tests menu is pre-populated in the Ulta Lab Tests system. Choose an RPR with treponemal confirm or a treponemal screen with reflex RPR. Use the same method over time to trend titers. Add HIVhepatitis B/C, and chlamydia/gonorrhea NAAT for a comprehensive sexual health screen. Review results with your clinician to plan treatment, partner notification, and follow-up testing.

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Name Matches

The RPR Test with Reflex to Titer and Confirmatory Testing screens for syphilis by detecting non-treponemal antibodies. If reactive, results are automatically followed by a titer to measure antibody concentration and confirmatory treponemal testing for accuracy. Doctors use this test to diagnose active or past syphilis, monitor treatment, or screen at-risk patients. Results provide vital insight into infection status, disease stage, and overall sexual health.

Blood
Blood Draw
Also Known As: Syphilis Test, Rapid Plasma Reagin Test

The Syphilis Test is an RPR Test with Reflex to Titer and Confirmatory Testing that screens for antibodies to Treponema pallidum. If reactive, additional testing confirms infection and measures antibody levels to assess disease activity. Doctors use this blood test to diagnose syphilis, determine stage, and monitor treatment response. It is widely used in STD screening, prenatal care, and early detection to prevent complications and transmission.

Blood
Blood Draw
Also Known As: RPR Test with Reflex to Titer and Confirmatory Testing, Rapid Plasma Reagin Test

The RPR (Monitor) with Reflex to Titer Test screens for syphilis by detecting antibodies to Treponema pallidum. If positive, a reflex titer determines antibody concentration to assess disease activity and treatment response. Doctors order this test to diagnose syphilis, monitor therapy, or check reinfection. Results provide essential information for managing active infection, confirming treatment success, and guiding follow-up care.

Also Known As: Syphilis RPR Test, Rapid Plasma Reagin Test

The Syphilis FTA-ABS Test (Fluorescent Treponemal Antibody Absorption) detects antibodies specific to Treponema pallidum, the bacteria that cause syphilis. Doctors use this confirmatory test after a positive screening to verify infection, even in late or latent stages. Results help distinguish syphilis from false positives, guiding diagnosis, treatment, and follow-up. This test is essential for accurate detection and long-term monitoring of syphilis.

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Blood Draw
Also Known As: Fluorescent Treponemal Antibody Absorption Antibodies Test

The Beta-2-Glycoprotein I IgA Antibody Test detects IgA antibodies targeting beta-2 glycoprotein I, helping identify autoimmune conditions and clotting disorders. Positive results may indicate antiphospholipid syndrome, thrombotic risk, or pregnancy complications. This test provides insight into immune activity, vascular health, and systemic conditions linked to abnormal coagulation and inflammation.

Blood
Blood Draw

The Beta-2-Glycoprotein I IgG Antibody Test detects IgG antibodies targeting beta-2 glycoprotein I, helping assess autoimmune disorders and clotting risk. Positive results may indicate antiphospholipid syndrome, pregnancy complications, or thrombotic conditions. This test provides insight into vascular health, immune response, and systemic disorders related to antibody activity and coagulation balance.

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Blood Draw

The Beta-2-Glycoprotein I IgM Antibody Test detects IgM antibodies targeting beta-2 glycoprotein I to help assess autoimmune activity and clotting disorders. Positive findings may suggest antiphospholipid syndrome, thrombotic risk, or recurrent miscarriage. This test provides insight into vascular health, immune regulation, and systemic disorders tied to antibody activity and coagulation balance.

Blood
Blood Draw

The Obstetric Panel is a prenatal blood test panel that screens for conditions affecting pregnancy and maternal health. It typically includes a Complete Blood Count, blood typing with Rh factor, antibody screen, and infectious disease testing such as hepatitis B, syphilis, rubella, and HIV. Doctors use this panel in early pregnancy to evaluate overall health, identify risks, and ensure safe monitoring for both mother and baby.


The Protein Total and Albumin Test measures overall protein levels and albumin, the main blood protein made by the liver. Abnormal levels may indicate liver disease, kidney disorders, malnutrition, or chronic inflammation. Doctors order this test for patients with swelling, fatigue, or abnormal lab results. Results provide critical insight into nutritional status, liver and kidney function, and help guide diagnosis and treatment of metabolic or chronic conditions.

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Blood Draw

The Rheumatoid Factor (RF) Test measures RF antibodies in blood to help diagnose rheumatoid arthritis and other autoimmune conditions. High RF levels may indicate rheumatoid arthritis, Sjögren’s syndrome, or other connective tissue diseases, though they can also appear in some infections. Doctors order this test to investigate joint pain, stiffness, or swelling. Results provide important insight into autoimmune activity, joint health, and inflammatory disease management.

Blood
Blood Draw
Also Known As: RF Test, Rheumatoid Arthritis Factor Test

The Tissue Plasminogen Activator Test measures tPA activity, a protein essential for breaking down blood clots and regulating fibrinolysis. Abnormal levels may indicate increased risk for thrombosis or bleeding disorders. By evaluating clot-dissolving capacity, this test provides insight into cardiovascular health, vascular function, and the balance between coagulation and fibrinolytic pathways in hemostatic regulation.

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Blood Draw

Blood
Blood Draw

Syphilis is an unwanted intruder that has hung around the human species for several thousand years. It's a sexually transmitted infection that appears in different stages. If it's not treated early, the consequences can be life-threatening.

Syphilis tests are the key to early diagnosis, treatment, and recovery. But how can you avoid catching syphilis? Is it curable? How long will symptoms last?

Let's take a closer look at syphilis testing to answer these questions and more.

What Is Syphilis?

Syphilis is a sexually transmitted disease (STD). According to the Centers for Disease Control, it is common, and the infection rate has been increasing in recent years. The Treponema pallidum bacterium causes syphilis.

Syphilis is one of the infectious diseases that a pregnant woman can pass on to her unborn child, known as congenital syphilis.

Risk Factors for Syphilis

Syphilis is almost always spread through sexual contact. During sex, transmission occurs through coming in contact with an infected person's sore.

The most common ways of contracting syphilis are through:

  • Unprotected sex
  • Sex with multiple partners
  • Men who have sex with men
  • Already having an HIV infection

All forms of sexual activity can put you at risk of catching syphilis. Men who have sex with men are at the highest risk of catching syphilis.

Causes of Syphilis

Syphilis is a bacterial infection. When an uninfected person comes into contact with a chancre, an ulcer on the genitals, they can catch the disease. This typically happens through the mucus membranes or minor cuts on the body.

What Are the Signs and Symptoms of Syphilis?

Syphilis has four main stages if left untreated. It can be hard to diagnose syphilis without screening tests, as it can look like other diseases.

Primary Stage

Syphilis first shows itself with a single chancre - a small painless ulcer. This can appear on the penis, scrotum, vagina, anus, or mouth. This is highly contagious and even kissing can spread the disease at this stage. 

Although a single chancre is common, sufferers can get many sores. If untreated, it will develop into the secondary stage.

Secondary Stage

The secondary stage shows up with skin rashes and lesions in the mouth, vagina, or anus. The skin rashes can appear on any part of the body. They may be painless, but are rough and have a red appearance. 

Other symptoms include:

  • Headaches
  • Swollen glands
  • Lesions in the groin, mouth, or under the arms
  • Muscle aches
  • Weight loss

As with the primary stage, these symptoms will pass in time. But the body cannot cure itself of syphilis. If you do not get treatment, it will move into the latent or tertiary stage.

Latent Syphilis

Once the secondary stage is over, the syphilis infection may lie dormant for a period of time. This stage can last for years.

Tertiary Syphilis

Tertiary syphilis can occur many years after the initial infection. The bacteria now start to affect organ systems, such as the liver, heart, vascular system, or joints. It can also affect the brain and the nervous system.

At any stage in the infection, syphilis can turn into neurosyphilis or ocular syphilis. These forms affect the nervous system and eyes respectively.

How Is Syphilis Diagnosed?

Syphilis is diagnosed using three methods. First, a physical examination checking the outward symptoms of the disease.

Secondly, syphilis tests will be run. Positive results on a syphilis blood test will show whether you have an active infection or have had syphilis in the past. Finally, if you have a chancre, your doctor may take a sample of fluid for testing.

The Lab Tests to Screen, Diagnose, and Monitor Syphilis

The key screening test for syphilis is the RPR (Monitor) test. This looks for the presence of antibodies and can detect syphilis in people who have the disease. This can also be used for monitoring the disease and detecting reinfection in the future.

Another test that is often used in conjunction with RPR is the FTA-ABS #4112. This test is not suitable for monitoring the effectiveness of treatment. However, it can be useful for initial diagnosis.

Frequently Asked Questions About Syphilis and Lab Testing for Syphilis

There are lots of rumors and stories online about syphilis. The most frequently asked questions about syphilis and syphilis lab tests include:

  • What should you not do if you have syphilis?

If you have syphilis, you should avoid any activity that could pass it on to another person. This would include having unprotected sex. You should also avoid using recreational drugs.

  • Is syphilis 100% curable?

It is possible to rid the body of the bacteria that causes the syphilis infection. In this way, it is 100% curable. That said, the treatment to clear the infection will not reverse the damage the condition has already done.

  • How long does it take for syphilis to go away after treatment?

If syphilis is detected early, it can be treated with a single injection of penicillin. If your doctor suspects that you have more long-term syphilis, a longer and more potent course of treatment may be needed. You will need to have further syphilis tests to check whether the infection has been cured.

Get Answers Fast With Syphilis Tests from Ulta Lab Tests

The only accurate way to know if you have this disease is through syphilis tests. They are quick, with results coming back in 2-4 days. Syphilis lab tests can help you know what you're dealing with, so you can start the right treatment as soon as possible.

Benefits of Syphilis Lab Testing with Ulta Lab Tests

Ulta Lab Tests offers syphilis tests that are highly accurate and reliable so you can make informed decisions about your health. Here are a few great things to love about Ulta Lab Tests:

  • You'll get secure and confidential results
  • You don't need health insurance
  • You don't need a physician's referral
  • You'll get affordable pricing
  • We offer a 100% satisfaction guarantee

Order your syphilis lab tests today and your results will be provided to you securely and confidentially online in 24 to 48 hours for most tests.

Take control with Ulta Lab Tests today!