To the Editor.—
The review of syphilis serology in the January Archives (116:84-89, 1980) by Felman and Nikitas is timely and informative. As a neurologist, I believe that their discussion of the CSF examination deserves two comments.First, to state that "a reactive CSF nontreponemal test is almost always an indication of neurosyphilis" and that "false-positive reactions to a non-treponemal test in the CSF rarely occur" is too dogmatic and perpetuates the myth that a reactive CSF serology means neurosyphilis. A few causes of false-positive CSF serology test results are mentioned, but the authors' list is incomplete, excluding more common entities, ie, subarachnoid hemorrhage, sarcoidosis, and collagen vascular disorders.1 As I have stated previously,2 I believe that a false-positive CSF serology is more frequent than the clinician realizes.Second, the issue of a routine CSF examination in patients
Delaney P. CSF Serology. Arch Dermatol. 1980;116(11):1227. doi:10.1001/archderm.1980.01640350017004
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