Table 1. Serologic testing results for Treponema pallidum subspecies endemicum and clinical findings for a symptomatic patient and family members, Canada, 2011*.

Family member†	Age, y/sex	VDRL result	TPPA result	Clinical findings	Molecular detection/PCR
Parent	40/F	Negative	Negative	None	ND
Parent	49/M	Negative	ND	None	ND
Child	1/F	1:32	4+‡	Skin papules, perianal condylomata	–§
Child	3/M	1:32	4+	Oral ulcer, hoarse voice, drooling, adenopathy	+¶
Child	5/F	Weakly reactive	4+	None	ND
Child	7/F	1:2	4+	None	ND
Child	10/F	1:8	4+	None	ND
Child	11/M	1:4	4+	None	ND
Child	14/M	1:16	4+	None	ND
Child	16/F	Weakly reactive	4+	None	ND
Child	19/F	1:16	4+	None	ND

*VDRL, Venereal Disease Research Laboratory test; TPPA, T. pallidum particle agglutination assay; ND, not done.
†All family members received intramuscular benzathine penicillin (1.2 million U if >10 y old, 0.6 million U if <10 y old) after confirmatory PCR results for the 3-year-old child.
‡Positive reactions were measured on a scale of 1–4, with 4 as the highest value.
§Oral swab specimen. Child had history of oral ulcer but had received a full course of azithromycin followed by oral lesion resolution before PCR was performed. She was born in Canada, had no travel history, and although the PCR result was negative, the test was performed after the patient received treatment. The patient had positive serologic test results for T. pallidum, a history of lesions characteristic of endemic syphilis, and no other plausible explanation for findings.
¶Oral ulcer swab specimen.