Regarding the diagnostic utility of CSF-VDRL in neurosyphilis, which statement is most accurate?

• A CSF-VDRL is highly sensitive but poorly specific for neurosyphilis
• B CSF-VDRL is no longer recommended because CSF FTA-ABS has replaced it entirely
• C CSF-VDRL has both high sensitivity and high specificity, making it the gold standard
• D A reactive CSF-VDRL is highly specific for neurosyphilis but has low sensitivity ✓

Explanation

CSF-VDRL is highly specific for neurosyphilis: when reactive in a nontraumatic tap, it is considered diagnostic. However, its sensitivity is low, reported around 30 to 70 percent, meaning a non-reactive CSF-VDRL does not rule out neurosyphilis. CSF FTA-ABS is more sensitive but less specific and is used as a sensitive rule-out test, not as a replacement for CSF-VDRL.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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Written and medically reviewed by the StethoPrep medical team.