Fig. 1
From: German guidelines on the diagnosis and treatment of neurosyphilis
Work-up in patients with suspected neurosyphilis. (1) Confirmation of a positive test using a confirmatory test is recommended (see text). (2) In patients with HIV, a discrete disruption of the blood–brain barrier may occasionally be seen. Also, a slightly increased cell count can be the result of the HIV infection itself. (3) If suspicion of neurosyphilis persists, treatment should be considered. (4) The VDRL test is recommended to create a basis for future follow up investigations. For details see text. TPPA = Treponema pallidum agglutination test; TPHA = T. pallidum hemagglutination test; TPLA = T. pallidum latex agglutination test, ITpA = intrathecal T. pallidum antibodies; AI = CSF/serum antibody index; VDRL = Venereal Disease Research Laboratory