What is the role of serologic testing in the diagnosis of neurosyphilis?

Updated: Jul 17, 2018
  • Author: Richard P Knudsen, MD, FAAN, FAAP; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Syphilitic infection produces 2 types of antibodies, the nonspecific reaginic (immunoglobulin E–mediated) antibody (ie, anticardiolipin) and specific antitreponemal antibody, which are measured by the nontreponemal and treponemal tests, respectively. Of note, cardiolipin is a substance extracted from heart tissue that is used as the antigen in flocculation and precipitation tests for syphilis. Test results can be reactive in persons with any treponemal infection, including yaws, pinta, and endemic syphilis (ie, bejel, which is due to another strain). The VDRL test and the rapid plasma reagin (RPR) test are nontreponemal tests, whereas FTA-ABS and microhemagglutination assay-T pallidum (MHA-TP) are treponemal tests.

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