Evaluation of treponemal serum tests performed on cerebrospinal fluid for diagnosis of neurosyphilis

American Journal of Clinical Pathology
Jeannette GuarnerKimberly Workowski

Abstract

We evaluated the use of treponemal serum tests in cerebrospinal fluid (CSF) to diagnose neurosyphilis since CSF-Venereal Disease Research Laboratory (VDRL) is specific but lacks sensitivity. We tested CSF specimens using the following treponemal serum tests: INNO-LIA, Treponema pallidum particle agglutination (TP-PA), Trep-Sure, and Maxi-Syph. The reference standard to calculate sensitivity and specificity was having two or more reactive/positive tests on CSF. The reference standard group included 11 cases that fulfilled the definition of neurosyphilis (reactive CSF-VDRL plus symptoms) and three cases that did not fulfill the definition: two cases had neurologic symptoms but a nonreactive CSF-VDRL, and one had several positive CSF syphilis tests (reactive VDRL and positive treponemal and syphilis polymerase chain reaction) but no history (referred sample). Controls included 18 patients in whom a CSF-VDRL was performed the same week as patients in the reference group. The sensitivity was 85.7% (12/14) for CSF-VDRL, 92.9% (13/14) for Trep-Sure, 100% (10/10) for Maxi-Syph, 92.3% (12/13) for INNO-LIA, and 83.3% (10/12) for TP-PA. Specificity was 100% for all tests. Treponemal serum tests performed on CSF were useful in identifying ...Continue Reading

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Citations

Apr 7, 2017·Journal of Clinical Microbiology·Christina M MarraLauren C Tantalo
Jun 25, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ina U ParkYetunde Fakile
Oct 12, 2017·Ocular Immunology and Inflammation·Parthopratim Dutta MajumderRupesh Agrawal
Jan 14, 2021·Sexually Transmitted Infections·Dongdong LiChuanmin Tao
Nov 24, 2020·Neurological Research and Practice·Matthias KleinJörg Weber
Feb 26, 2021·Frontiers in Cellular and Infection Microbiology·Yuting LuoYongjian Xiao
Jun 16, 2021·BMC Infectious Diseases·Gustavo Henrique Pereira BoogAnna S Levin

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