07-07-2008, 06:55 AM
diagnosis
of neurosyphilis usually depends on various combinations
of reactive serologic test results, CSF cell count or protein, or
a reactive VDRL-CSF with or without clinical manifestations.
The CSF leukocyte count usually is elevated (>5 white blood
cell count [WBC]/mm3) in patients with neurosyphilis; this
count also is a sensitive measure of the effectiveness of therapy.
The VDRL-CSF is the standard serologic test for CSF, and
when reactive in the absence of substantial contamination of
CSF with blood, it is considered diagnostic of neurosyphilis.
However, the VDRL-CSF might be nonreactive even when
neurosyphilis is present. Some specialists recommend performing
an FTA-ABS test on CSF. The CSF FTA-ABS is less specific
(i.e., yields more false-positive results) for neurosyphilis
than the VDRL-CSF, but the test is highly sensitive. Therefore,
some specialists believe that a negative CSF FTA-ABS
test excludes neurosyphilis.
of neurosyphilis usually depends on various combinations
of reactive serologic test results, CSF cell count or protein, or
a reactive VDRL-CSF with or without clinical manifestations.
The CSF leukocyte count usually is elevated (>5 white blood
cell count [WBC]/mm3) in patients with neurosyphilis; this
count also is a sensitive measure of the effectiveness of therapy.
The VDRL-CSF is the standard serologic test for CSF, and
when reactive in the absence of substantial contamination of
CSF with blood, it is considered diagnostic of neurosyphilis.
However, the VDRL-CSF might be nonreactive even when
neurosyphilis is present. Some specialists recommend performing
an FTA-ABS test on CSF. The CSF FTA-ABS is less specific
(i.e., yields more false-positive results) for neurosyphilis
than the VDRL-CSF, but the test is highly sensitive. Therefore,
some specialists believe that a negative CSF FTA-ABS
test excludes neurosyphilis.