Syphilis - detection

Detection of Treponema pallidum subspecies pallidum (syphilis)
Microbiology
Bacteriology
○ Serous exudate from lesion or chancre
Other Information
○ Blood sample for syphilis serology should be sent in parallel

○ A swab received in charcoal or antibiotic transport medium is not an acceptable specimen. If smears are prepared too thick or show signs of gross contamination with blood, the sample will not be tested.
○ Direct fluorescence for detection of T. pallidum is indicated for the diagnosis of primary and secondary syphilis from suspected chancre or lesions.
○ Lesion/chancre exudate: microscope slides to prepare smear (1 slide)
Lesion/chancre exudate
○ Cleanse lesion with saline moistened sterile gauze prior to de-roofing an intact papule or healing ulcer with dry gauze or a scalpel. Squeeze clear serous fluid and collect with the edge of a coverslip or microscope slide. Place coverslip onto a slide and press gently but evenly between two pieces of filter paper.
○ Collect exudate from vaginal or cervical lesions using a bacteriological loop or Pasteur pipette and transfer to a slide. If necessary, the site can be pressed with a Kelly clamp.

Refer to section Sample Processing / Delivery
PHOL
○ 2 days
416-586-4800 extension 4630
NO
○ Label specimen container. Place specimens in biohazard bag and seal.

○ Specimens should be transported to the UHN/SH Microbiology Laboratory at refrigeration temperature (2-8˚C) ASAP after collection

○ The specimen will be referred to the Public Health Ontario Laboratory for testing