A 32-year-old man comes to the office due to 2 weeks of fever, malaise, and arthralgia. Temperature is 38.2 C (100.8 F) and pulse is 102/min. Physical examination reveals several enlarged cervical, axillary, and inguinal lymph nodes and a diffuse maculopapular skin rash. Serum aminotransferase levels are elevated. During further testing, the patient's serum is added to a mixture of cardiolipin, cholesterol, and lecithin, which leads to extensive clumping and flocculation. Evaluation for antibodies directed against which of the following is the best next step in management of this patient?

Question

A 32-year-old man comes to the office due to 2 weeks of fever, malaise, and arthralgia.  Temperature is 38.2 C (100.8 F) and pulse is 102/min.  Physical examination reveals several enlarged cervical, axillary, and inguinal lymph nodes and a diffuse maculopapular skin rash.  Serum aminotransferase levels are elevated.  During further testing, the patient's serum is added to a mixture of cardiolipin, cholesterol, and lecithin, which leads to extensive clumping and flocculation.  Evaluation for antibodies directed against which of the following is the best next step in management of this patient?

Quizplus · Accepted Answer

Eductional Objective: Syphilis is caused by the spirochete Treponema pallidum.  Confirmation of the diagnosis requires 2 forms of serologic testing to prevent false-positive results.  Nontreponemal tests (eg, rapid plasma reagin, VDRL) evaluate for anticardiolipin antibodies (nonspecific); treponemal tests evaluate for antibodies targeted against T pallidum.

A 32-Year-Old Man Comes to the Office Due to 2