CSF-VDRL test

Answer 1

Definition

The CSF-VDRL test is used to diagnose neurosyphilis. This test looks for antibodies called reagins, which are sometimes produced by the body in reaction to the syphilis-causing bacteria.

See also: VDRL

Alternative Names

Venereal disease research laboratory slide test - CSF

How the test is performed

The test is performed on a CSF sample obtained by lumbar puncture (spinal tap).

How to prepare for the test

Before the procedure, you will be asked to review the risks and sign a consent form.

How the test will feel

Usually, discomfort associated with the lumbar puncture is mild to moderate. The entire procedure usually takes about 30 minutes but may take longer. The actual fluid collection only takes a few minutes.

Why the test is performed

The CSF-VDRL test is used to diagnose syphilis in the brain or spinal cord. Brain and spinal cord involvement usually indicates late stage (tertiary) syphilis.

Blood screening tests, such as VDRL and RPR, are more effective during middle stage (secondary) syphilis.

Normal Values

A negative result is normal.

However, false-negatives can occur. This means you can have syphilis and have a normal CSF-VDRL test result. Therefore, a negative test does not always rule out the disease. Other markers of inflammation, such as elevated protein levels or excess white blood cells, may be used to diagnose neurosyphilis.

What abnormal results mean

A positive result is abnormal and indicates neurosyphilis.

What the risks are

Risks of lumbar puncture include:

• Hypersensitivity (allergic) reaction to the anesthetic
• Discomfort during the test
• Headache after the test
• Bleeding into the spinal canal
• Brain herniation (if performed on a person with increased intracranial pressure) which may result in brain damage or death
• Damage to the spinal cord or nerve roots

References

Hook EW III. Syphilis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 340.

Fletcher JJ, Nathan BR. Cerebrospinal fluid and intracranial pressure. In: Goetz, CG, eds. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 26.

Answer 2

Definition

The CSF-VDRL test is used to diagnose neurosyphilis. It looks for substances called reagins, which are sometimes produced by the body in reaction to the syphilis-causing bacteria.

See also: VDRL

Alternative Names

Venereal disease research laboratory slide test - CSF

How the test is performed

A sample of spinal fluid is needed. For information on how this is taken, see: Lumbar puncture (spinal tap)

Why the test is performed

The CSF-VDRL test is done to diagnose syphilis in the brain or spinal cord. Brain and spinal cord involvement is usually a sign of late stage syphilis.

Blood screening tests (VDRL and RPR) are better at detecting middle stage (secondary) syphilis.

Normal Values

A negative result is normal.

However, false-negatives can occur. This means you can have syphilis even if this test is normal. Therefore, a negative test does not always rule out the disease. Other signs and tests may be used to diagnose neurosyphilis.

What abnormal results mean

A positive result is abnormal and is a sign of neurosyphilis.

References

Tramont EC. Treponema pallidum (Syphilis). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 238.

Fletcher JJ, Nathan BR. Cerebrospinal fluid and intracranial pressure. In: Goetz, CG, eds. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 26.

Reviewed By

Review Date: 08/24/2011

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.