Cerebrospinal Fluid in the Diagnosis of Syphilis

Excerpt

To the editor: In their recent study Dans and coworkers (1) question the appropriateness of the current recommendations of the Centers for Disease Control (CDC) for lumbar puncture in patients with asymptomatic untreated syphilis. Their study appears to examine the prevalence of neurosyphilis in 2536 patients. However, only 226 patients had a positive serum fluorescent treponemal antibody absorption (FTA-ABS) test, and only 40 patients were documented by chart review to have had lumbar puncture specifically for assessment of "asymptomatic" neurosyphilis. Because the CDC criteria for doing a lumbar puncture to rule out neurosyphilis specify that the patient should have a