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December 1976

Late Syphilis: Otologic Symptoms and Results of the FTA-ABS Test

Author Affiliations

From the Section of Otolaryngology (Head and Neck Surgery), Wadsworth Hospital Center, and the Department of Surgery, UCLA School of Medicine, Los Angeles.

Arch Otolaryngol. 1976;102(12):729-731. doi:10.1001/archotol.1976.00780170047005

• The clinician occasionally encounters a patient whose cochleovestibular symptoms are thought to be due to late syphilis mainly on the basis of a reactive FTA-ABS test. I describe 21 such patients, 11 of whom had either a spurious-or a false-positive reaction.

The following suggestions may avoid an inaccurate diagnosis of late syphilis in such patients: (1) repeat all reactive serological tests for syphilis (STS); (2) rule out false-positive reactions; (3) request the degree of fluorescence (1+ to 4+) on all reactive FTA-ABS tests; (4) obtain a Treponema pallidum immobilization (TPI) test on all patients with repeatedly reactive (1+) FTA-ABS tests—a nonreactive TPI test rules out the diagnosis of syphilis; (5) if a TPI test cannot be performed, a repeatedly reactive (1+) FTA-ABS test in the absence of a reactive nontreponemal STS probably represents a false-positive reaction; (6) clinical judgment is the final determinant of whether a patient has or should be treated for late syphilis.

(Arch Otolaryngol 102:729-731, 1976)