Examination of the cerebrospinal fluid in syphilis

In the diagnosis of neurosyphilis, a cerebrospinal fluid cell count or cerebrospinal fluid total protein are inconclusive by themselves, but together with a cerebrospinal fluid VDRL are of great diagnostic value. At present, the VDRL Slide Test on Spinal Fluid remains the serologic test of choice for the diagnosis of neurosyphilis. The significance and specificity of treponemal tests on spinal fluid remain to be established. Like all other laboratory tests, cerebrospinal fluid findings may be variable and an absolute diagnosis of neurosyphilis should not be made on the result of any one laboratory test alone, but should be viewed in light of all laboratory evidence, including serum serologic tests, and clinical findings.