A case of syphilis with an extremely high RPR titer

It remains unidentified why this patient has an extremely high Rapid Plasma Reagin Titer (RPR) 1: 2048. A false positive result was ruled out by a Treponemal test. To ensure accuracy, repeat tests were requested for both the Non-Treponemal and Treponemal Tests in the same laboratory, and the results came back the same. In the Traditional Algorithm, Positive Nontreponemal Syphilis screening tests are confirmed by Treponemal tests, although the latter is not quantitative. The lack of full sensitivity in the Traditional Algorithm Testing has led the CDC and some other centers to adopt Reverse Sequence Testing. The resurgence of syphilis after 20 years could lead to mutagenic strain thus making it relevant for a need for heightened awareness.