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  #1  
Old 05-02-2014
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Question VDRL interpretation

How to interpret VDRL results !!!?

When is it POSITIVE and at which STAGE !?

Just saw a UW Q that said +ve VDRL and Pleocytosis = Tertiary syphillis NOT PRIMARY

I am all confused ; anyone have some clear concepts ?
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Old 05-03-2014
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If I remember this question correctly, they tested the patient's CSF and not his blood so he has neurosyphilis which means tertiary syphilis. But I could be talking about another question!! Kindly post the full question so I can be of help
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Old 05-03-2014
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Quote:
Originally Posted by federer_1490 View Post
If I remember this question correctly, they tested the patient's CSF and not his blood so he has neurosyphilis which means tertiary syphilis. But I could be talking about another question!! Kindly post the full question so I can be of help
well i think it is the question
the findings in the pt were :
"painless indurated lesion on vulva "
"serum VDRL is positive"
" Lumbar puncture reveals pleocytosis and a positive VDRL "

I think i got what you are saying .. i always thought that VDRL was a test done on blood and that's it ;
so the UW concept says : a +ve VDRL and pleocytosis in CSF diagnoses neurosyphilis

SO to make sure i got it right - if the pt presented with the same lesion and serum VDRL THEN IT IS 1RY .... if we add on a 3rd piece of info of +ve VDRL in CSF .. IT BECOMES 3RY .
Right ?
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Old 05-03-2014
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Exactly. Both primary and secondary syphilis lesions are painless and indurated and both will have a positive serum VDRL so this alone won't help you differentiate primary from secondary.
So if you see only one lesion which is the painless chancre then it's primary. If u see one or multiple lesions (condyloma lata on the genitals) + fever + maculopapular rash that involves the palm and soles + lymphadenopathy then it's secondary (which has systemic symptoms)

Don't forget that there's a latent stage after secondary syphilis that has no symptoms but will have positive serum VDRL.

And finally a +ve CSF VDRL ==> tertiary syphilis.
Hope this helps
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The above post was thanked by:
hope007 (05-07-2014)



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