[Current aspects in the diagnosis of syphilis]

In order to present the diagnostic possibilities of treponemal infections, syphilis can be chosen as an example. The direct detection of the pathogen is limited mainly to the early stages of the disease. The diagnostic significance of the PCR as a possible alternative method cannot yet be estimated. The concept for the serodiagnosis of syphilis which includes the TPHA assay as a screening test, the FTA-ABS as the confirmatory test, and the detection of T. pallidum specific IgM antibodies and lipoidal antibodies for the estimation of the disease activity has proven to be very successful. Whether the enzyme immunoassays can replace or supplement the conventional methods has yet to be evaluated critically. There is no possibility for a general statement on the symptomatology of syphilis and the pattern of serological reactions in HIV-infected persons, since the immune system function of each individual is of great importance.