Repeat serology to help determine if: Early primary syphilis OR Late latent/tertiary syphilis OR Previously treated syphilis OR In persons from endemic countries, yaws (e.g., Caribbean), pinta (e.g., Central America) or bejel OR Lyme Disease If repeat serology is unchanged this is likely to be a false positive If laboratory does not perform confirmatory testing, interpretation is as follows: Syphilis, any stage (Note that more likely to be infectious if RPR titre ≥ 32 dilutions) OR Previously treated syphilis OR Follow-up of treated syphilis OR In persons from endemic countries, yaws (e.g., Caribbean), pinta (e.g., Central America) or be ...[+++]jel OR Lyme Disease

Early primary syphilis OR Late latent/tertiary syphilis OR Previously treated syphilis OR In persons from endemic countries, yaws (e.g., Caribbean), pinta (e.g., Central America) or bejel OR Lyme Disease

Usually treated syphilis OR Early infection (early primary syphilis) OR Late latent/tertiary syphilis OR In persons from endemic countries, yaws (e.g., Caribbean), pinta (e.g., Central America) or bejel OR Lyme Disease

The risk of transmission in untreated women is 70-100% with primary or secondary syphilis, 40% with early latent syphilis and 10% in late latent stages in pregnancy.

HIV patients with neurologic symptoms or signs, late latent syphilis, RPR ≥ 1:32 dilutions, CD4 < 350 cells/µL or treated syphilis with suboptimal decline in VDR/RPR titre; some experts recommend CSF examination in all HIV-infected individuals.

However, in patients with suspected primary syphilis or late latent syphilis, the NTT may be non-reactive, and it is then appropriate to add a treponemal test to the initial screen or, in the case of primary syphilis, to repeat the NTT after 2–4 weeks.