Test Catalog

Test ID: TREPE    
Treponema pallidum Immunostain, Technical Component Only

Useful For Suggests clinical disorders or settings where the test may be helpful

Identification of Treponema pallidum in tissues

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Syphilis is caused by infection with the spirochete Treponema pallidum. Transmission of T pallidum occurs via penetration of the spirochetes through mucosal membranes and abrasions on epithelial surfaces. It is primarily spread through sexual contact, but can be spread by exposure to blood products and transferred in utero.

Interpretation Provides information to assist in interpretation of the test results

This test includes only technical performance of the stain (no pathologist interpretation is performed). Mayo Clinic cannot provide an interpretation of tech only stains outside the context of a pathology consultation. If an interpretation is needed, refer to PATHC / Pathology Consultation for a full diagnostic evaluation or second opinion of the case. All material associated with the case is required. Additional specific stains may be requested as part of the pathology consultation, and will be performed as necessary at the discretion of the Mayo pathologist.


The positive and negative controls are verified as showing appropriate immunoreactivity and documentation is retained at Mayo Clinic Rochester. If a control tissue is not included on the slide, a scanned image of the relevant quality control tissue is available upon request. Contact 855-516-8404.


Interpretation of this test should be performed in the context of the patient's clinical history and other diagnostic tests by a qualified pathologist.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Contamination and cross-reactivity with other microorganisms, including other spirochetes, may lead to nonspecific staining. Clinical and serologic correlation is recommended for diagnostic confirmation.


Age of a cut paraffin section can affect immunoreactivity. Stability thresholds vary widely among published literature and are antigen-dependent. Best practice is for paraffin sections to be cut fresh.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Fernandez-Flores A: Immunostaining for Treponema pallidum: caution in its evaluation. Am J Dermatopathol 2010;32(5):523-526

2. Martin-Ezquerra G, Fernandez-Casado A, Barco D, et al: Treponema pallidum distribution patterns in mucocutaneous lesions of primary and secondary syphilis: an immunohistochemical and ultrastructural study. Hum Pathol 2009;40:624-630

3. Quatresooz P, Perard GE: Skin homing of Treponema pallidum in early syphilis-an immunohistochemical study. Appl Immunohistochem Mol Morphol 2009;17(1):47-50

4. Buffet M, Grange PA, Gerhardt P, et al: Diagnosing Treponema pallidum in secondary syphilis by PCR and immunohistochemistry. J Investig Dermatol 2007;127:2345-2350