{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:49:24Z","timestamp":1784872164829,"version":"3.55.0"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,12,6]],"date-time":"2017-12-06T00:00:00Z","timestamp":1512518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2018,3]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>There is no clear consensus on the diagnosis of neurosyphilis. The Venereal Disease Research Laboratory (VDRL<\/jats:styled-content>) test from cerebrospinal fluid (CSF<\/jats:styled-content>) has traditionally been considered the gold standard for diagnosing neurosyphilis but is widely known to be insensitive.<\/jats:p><\/jats:sec>Objective<\/jats:title>In this study, we compared the clinical and laboratory characteristics of true\u2010positive VDRL<\/jats:styled-content>\u2010CSF<\/jats:styled-content> cases with biological false\u2010positive VDRL<\/jats:styled-content>\u2010CSF<\/jats:styled-content> cases.<\/jats:p><\/jats:sec>Methods<\/jats:title>We retrospectively identified cases of true and false\u2010positive VDRL<\/jats:styled-content>\u2010CSF<\/jats:styled-content> across a 3\u2010year period received by the Immunology and Serology Laboratory, Singapore General Hospital. A biological false\u2010positive VDRL<\/jats:styled-content>\u2010CSF<\/jats:styled-content> is defined as a reactive VDRL<\/jats:styled-content>\u2010CSF<\/jats:styled-content> with a non\u2010reactive Treponema pallidum<\/jats:italic> particle agglutination (TPPA<\/jats:styled-content>)\u2010CSF<\/jats:styled-content> and\/or negative Line Immuno Assay (LIA<\/jats:styled-content>)\u2010CSF<\/jats:styled-content> IgG. A true\u2010positive VDRL<\/jats:styled-content>\u2010CSF<\/jats:styled-content> is a reactive VDRL<\/jats:styled-content>\u2010CSF<\/jats:styled-content> with a concordant reactive TPPA<\/jats:styled-content>\u2010CSF<\/jats:styled-content> and\/or positive LIA<\/jats:styled-content>\u2010CSF<\/jats:styled-content> IgG.<\/jats:p><\/jats:sec>Results<\/jats:title>During the study period, a total of 1254 specimens underwent VDRL<\/jats:styled-content>\u2010CSF<\/jats:styled-content> examination. Amongst these, 60 specimens from 53 patients tested positive for VDRL<\/jats:styled-content>\u2010CSF<\/jats:styled-content>. Of the 53 patients, 42 (79.2%) were true\u2010positive cases and 11 (20.8%) were false\u2010positive cases. In our setting, a positive non\u2010treponemal serology has 97.6% sensitivity, 100% specificity, 100% positive predictive value and 91.7% negative predictive value for a true\u2010positive VDRL<\/jats:styled-content>\u2010CSF<\/jats:styled-content> based on our laboratory definition. HIV<\/jats:styled-content> seropositivity was an independent predictor of a true\u2010positive VDRL<\/jats:styled-content>\u2010CSF<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Biological false\u2010positive VDRL<\/jats:styled-content>\u2010CSF<\/jats:styled-content> is common in a setting where patients are tested without first establishing a serological diagnosis of syphilis. Serological testing should be performed prior to CSF<\/jats:styled-content> evaluation for neurosyphilis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.14681","type":"journal-article","created":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T21:46:38Z","timestamp":1510177598000},"page":"474-481","source":"Crossref","is-referenced-by-count":15,"title":["Biological false\u2010positive venereal disease research laboratory test in cerebrospinal fluid in the diagnosis of neurosyphilis \u2013 a case\u2010control study"],"prefix":"10.1111","volume":"32","author":[{"given":"S.","family":"Zheng","sequence":"first","affiliation":[{"name":"Department Infectious Diseases Changi General Hospital Singapore Singapore"},{"name":"Department Infectious Diseases Singapore General Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.J.","family":"Lin","sequence":"additional","affiliation":[{"name":"Institute of Infectious Diseases and Epidemiology Tan Tock Seng Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.H.","family":"Chan","sequence":"additional","affiliation":[{"name":"Biostatistics Unit National University of Singapore Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.C.L.","family":"Ngan","sequence":"additional","affiliation":[{"name":"Department of Microbiology Singapore General Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,6]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"1","article-title":"Sexually transmitted diseases treatment guidelines 2015","volume":"64","author":"Workowski KA","year":"2015","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12734"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.20147"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/167484"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-104-1-86"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1966.03100100120044"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.26.6.591"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1980.03310070038026"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/IPC.0b013e31816fd59e"},{"key":"e_1_2_6_11_1","unstructured":"TungYJ HsiehMH ChenYH HuangCH.False Positive Venereal Disease Research Laboratory of Cerebrospinal Fluid. Abstracts of the 7th International Congress of the Asia Pacific Society of Infection Control Taipei Taiwan March 26\u201029 2015."},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1086\/381227"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.8.1.1"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-009-0019-1"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdv.14681","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.14681","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T10:03:20Z","timestamp":1695549800000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.14681"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,6]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1111\/jdv.14681"],"URL":"https:\/\/doi.org\/10.1111\/jdv.14681","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,6]]}}}