Evaluation of Treponemal Serum Tests Performed on Cerebrospinal Fluid for Diagnosis of Neurosyphilis

Details

• Alternative Title:
  Am J Clin Pathol
• Personal Author:
  Guarner, Jeannette ; Jost, Heather ; Pillay, Allan ; Sun, Yongcheng ; Cox, David ; Notenboom, Robert ; Workowski, Kimberly
• Description:
  Objectives
  
  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.
  
  Methods
  
  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.
  
  Results
  
  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.
  
  Conclusions
  
  Treponemal serum tests performed on CSF were useful in identifying two patients with nonreactive CSF-VDRL.
  
  
• Subjects:
  Adolescent Adult Aged Aged, 80 And Over Antibodies, Bacterial Article Case-Control Studies Cerebrospinal Fluid DNA, Bacterial Female Humans Male Middle Aged Neurosyphilis Sensitivity And Specificity Syphilis Serodiagnosis Treponemal Tests Treponema Pallidum VDRL Young Adult

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• Source:
  Am J Clin Pathol. 143(4):479-484.
• Pubmed ID:
  25779998
• Pubmed Central ID:
  PMC4837891
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States ; P30 AI050409/AI/NIAID NIH HHS/United States
• Volume:
  143
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:b39bf6ab28a5403283f8035bf327cb78dc4805d692d136ca44cf09f1c2862d6f
• Download URL:
  https://stacks.cdc.gov/view/cdc/39047/cdc_39047_DS1.pdf
• File Type:
  [PDF - 71.95 KB ]