Neurosyphilis and Cerebrospinal Fluid Tests

Excerpt

To the editor: We agree with several of the points made by Dans and colleagues (1) in their recent review on the inappropriate use of the cerebrospinal fluid (CSF) VDRL test, and we believe it bears reemphasizing that the role of the CSF-VDRL test is to "rule in" rather than "rule out" neurosyphilis. Additionally, the importance of the serum fluorescent treponemal antibody absorption (FTA-ABS) or the microhemagglutination Treponema pallidum (MHA-TP) tests over the serum VDRL test in persons with late syphilis should be emphasized. We are concerned, however, with the authors' conclusion that the Centers for Disease Control (CDC) should