Warning

logo

address

website

telephone numbers etc

Date:

Patient:

DOB:

 

You have recently been receiving treatment for syphilis here at the XXX Department in NHS XXX.

When you complete your treatment, some of your syphilis blood tests will change showing a response to the antibiotics. However some of the syphilis blood tests will probably remain positive for the rest of your life and this will show up if you are tested for syphilis again in the future.

We therefore provide you with the following information to share with other health professionals if you are tested for syphilis again in the future, such as if you are getting tested at another sexual health clinic, at your GP or when you are pregnant. This will help them in understanding the results that come back. It is important that you keep this information in a safe place.

If you have any questions please contact the helpline number above.

 

Stage of Syphilis during which treatment was commenced………………………………………………

Dates VDRL/RPR Anti-Trep EIA IgG Anti-Trep EIA Igm TPPA/TPHA
  negative / positive  quantitative negative/ equivocal/ positive quantitative negative/ equivocal/ positive quantitative negative/ equivocal/ positive
               

Initial

Serology

on

--/--/--

              

Final

Serology

on

--/--/--

             

 

Treatment Received

Date Antibiotic  Dose  Route  Comments 
         
         
         

 

Yours sincerely,

 

On behalf of XXX, NHS XXX

Editorial Information

Last reviewed: 30/09/2022

Next review date: 30/09/2024

Author(s): West of Scotland Managed Clinical Network in Sexual Health Clinical Guidelines Group .

Version: 7.1

Approved By: West of Scotland Managed Clinical Network in Sexual Health