Which CSF findings are typical in neurosyphilis?

Which CSF findings are typical in neurosyphilis?

• A. Lymphocytic pleocytosis with elevated protein and a positive VDRL/RPR in CSF.
• B. Neutrophilic pleocytosis with normal protein.
• C. Lymphocytic pleocytosis with low protein.
• D. High glucose with no pleocytosis.

Answer: (A)

Neurosyphilis causes a chronic meningitic process in the CNS, which classically yields a CSF profile with lymphocytic pleocytosis and elevated protein due to inflammation of the meninges and disruption of the blood-brain barrier. The most characteristic and specific finding is a positive CSF non-treponemal test (VDRL or RPR), seen alongside these inflammatory changes. Glucose in CSF is typically normal in neurosyphilis. This pattern helps distinguish it from other meningitides. A neutrophilic pleocytosis with normal protein points more to acute bacterial meningitis. Lymphocytic pleocytosis with low protein is not typical for neurosyphilis, and high glucose with no pleocytosis suggests absence of inflammatory meningitis.

Neurosyphilis causes a chronic meningitic process in the CNS, which classically yields a CSF profile with lymphocytic pleocytosis and elevated protein due to inflammation of the meninges and disruption of the blood-brain barrier. The most characteristic and specific finding is a positive CSF non-treponemal test (VDRL or RPR), seen alongside these inflammatory changes. Glucose in CSF is typically normal in neurosyphilis.

This pattern helps distinguish it from other meningitides. A neutrophilic pleocytosis with normal protein points more to acute bacterial meningitis. Lymphocytic pleocytosis with low protein is not typical for neurosyphilis, and high glucose with no pleocytosis suggests absence of inflammatory meningitis.