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Original Contributions
July 13, 1964

Syphilis With a Negative Blood Test Reaction

Author Affiliations

Boston; West Roxbury, Mass

Dr. Spangler is an associate in medicine (Dermatology) Peter Bent Brigham Hospital, and assistant in dermatology at Harvard Medical School and Massachusetts General Hospital. Dr. Jackson is an associate in medicine, Peter Bent Brigham Hospital and an instructor in medicine, Harvard Medical School. Dr. Fiumara is director of the Division of Communicable and Venereal Diseases, Massachusetts Department of Public Health and an associate clinical professor of dermatology, Boston University School of Medicine. Dr. Warthin is Chief of Medicine, Veterans Administration Hospital, and a clinical professor of medicine at Harvard Medical School.

JAMA. 1964;189(2):87-90. doi:10.1001/jama.1964.03070020015003

The reappearance of syphilis as an important infectious disease in this country prompted a review of the methodology of diagnosis as viewed by the practitioner. Blind reliance on standard serologic tests for syphilis may be misleading. In our study, the disease, in various stages, was present in 24 patients whose serologic tests were negative. In 16, the negative test was the result of a positive prozone reaction, and the reagin became positive upon dilution of the serum. The newer treponemol tests (RPCF and TPI), darkfield and spinal fluid examinations were also valuable in establishing the diagnosis. The clinician must be aware of the possibility of active syphilis with a "false negative serology."