Syphilis (Reverse Sequence) Testing Algorithm

Testing for Treponema pallidum, the causative agent for syphilis, can be done either using the traditional method or the newer reverse sequence method. Reverse sequence testing detects primary and treated infection but cannot distinguish between an active infection and a previously treated infection. An initial workup for syphilis using the reverse sequence includes Treponema pallidum antibody testing followed by confirmation by rapid plasma reagin (RPR).