Abstract
Syphilis is a re-emerging sexually-transmitted infection, caused by the spirochete Treponema pallidum, that may penetrate early into the central nervous system. The venereal disease research laboratory test (VDRL) on the cerebrospinal fluid (CSF) is the most widely used for neurosyphilis diagnosis. We evaluated the performance of two other nontreponemal tests (rapid plasma reagin [RPR] and unheated serum reagin [USR] tests) in comparison with the VDRL in CSF. We analyzed CSF samples from 120 individuals based on VDRL reactivity in the CSF and the clinical picture of neurosyphilis. High inter-rater reliability was found among all three tests, with equivalent sensitivity and specificity. Intraclass correlation coefficient for absolute agreement was 1 for VDRL versus USR, 0.99 for VDRL versus RPR, and 0.99 for RPR versus USR. Rapid plasma reagin and unheated serum reagin tests were identified as excellent alternatives for neurosyphilis diagnosis.
References
Sep 18, 2003·JAMA : the Journal of the American Medical Association·Matthew R GoldenKing K Holmes
Jul 16, 2008·Journal of Clinical Laboratory Analysis·Rita CastroFilomena da Luz Martins Pereira
Dec 3, 2011·The Journal of Clinical Investigation·Emily L Ho, Sheila A Lukehart
Mar 17, 2012·Sexually Transmitted Diseases·Emily L Ho, Christina M Marra
May 18, 2012·Sexually Transmitted Diseases·Christina M MarraTrudy Jones
Apr 26, 2013·Dermatology : International Journal for Clinical and Investigative Dermatology·Hui-Lin ZhangTian-Ci Yang
Dec 18, 2013·Journal of Clinical Microbiology·Lin ZhuArlene C Seña
Dec 25, 2013·Handbook of Clinical Neurology·Joseph R Berger, Dawson Dean
Apr 22, 2015·Current Infectious Disease Reports·Salman Bhai, Jennifer L Lyons
Dec 4, 2015·Continuum : Lifelong Learning in Neurology·Christina M Marra
Nov 5, 2016·Clinica Chimica Acta; International Journal of Clinical Chemistry·Li-Rong LinTian-Ci Yang
Nov 24, 2016·Clinica Chimica Acta; International Journal of Clinical Chemistry·Man-Li TongTian-Ci Yang
Feb 15, 2017·AIDS Education and Prevention : Official Publication of the International Society for AIDS Education·Heather R Rodriguez, Aram Dobalian