Lab Test

VDRL, CSF

Test Codes

Antrim #30938, EPIC: LAB5773, SOFT: CVDRL

Specimen Collection Criteria

Collect: Cerebrospinal fluid (CSF) in sterile collection container. (Minimum: 0.5 mL)

Send specimen to the Laboratory immediately for processing.

Physician Office/Draw Specimen Preparation

Arrange for transportation to the Laboratory prior to specimen collection. Refrigerate (2-8°C or 36-46°F) specimen immediately after collection and maintain refrigerated prior to transport. (Minimum: 0.5 mL)

Preparation for Courier Transport

Transport: CSF in a sterile collection container, refrigerated (2-8°C or 36-46°F). (Minimum: 0.5 mL)

Rejection Criteria

Specimens not collected and processed as indicated.

Inpatient Specimen Preparation

Transport specimen to the Laboratory immediately after collection. (Minimum: 0.5 mL)

In-Lab Processing

Maintain specimen refrigerated (2-8°C or 36-46°F) if not analyzed immediately.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 5 days
Frozen (-20°C/-4°F or below): 1 year

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 30 days

Laboratory

Royal Oak Special Testing Laboratory

Performed

Monday, Thursday.
Results available within 3 business days.

Reference Range

Non-Reactive.

Test Methodology

Flocculation.

Interpretation

In neurosyphilis, the spinal fluid is reactive in all cases of general paresis but in only 70% of tabes dorsalis cases. In latent syphilis, the spinal fluid is sometimes positive when the serum is non-reactive.

Clinical Utility

VDRL tests are not absolutely specific but they are practical, inexpensive, and reproducible.

Clinical Disease

Syphilis is a complex systemic illness caused by the spirochete Treponema pallidum. The natural course of syphilis can be divided into five stages. The first stage is an incubation period lasting approximately 3 weeks which is followed by a primary stage characterized by a non-painful skin lesion (chancre) associated with regional lymphadenopathy and early bacteremia. This stage is followed by a secondary bacteremic or disseminated stage accompanied by generalized mucocutaneous lesions and lymphadenopathy. A period of subclinical (latent syphilis) is followed by a late or tertiary stage in a small number of patients. The latent or tertiary stage is characterized by progressive disease involving the ascending aorta and /or the central nervous (CNS), but any organ system can be involved. (1)

Disease Reporting

This is a reportable infection and positive results will be reported to the Oakland County Health Department. For more information on reportable diseases, contact the Beaumont Epidemiology Department at 248-551-4040.

Epidemiology

The vast majority of syphilis cases occur in the most sexually active age group (15-30 years old). Increased cases have been seen in heterosexuals. There has been a dramatic increase of syphilis in women and neonates. The increased number of syphilis cases has been attributed to the exchange of sex for drugs, and concomitant infections with HIV. (1)

Incubation Period

Average incubation period is 21 days (range; 3-90 days). (1, 2)

Transmission

Syphilis is transmitted by sexual contact, by passage through the placenta (congenital syphilis), by kissing, by transfusion of fresh human blood, or by accidental direct inoculation (e.g., needle stick, or when handling infected clinical material).(1)

Reference

1. Tramont,E. Treponema Pallidum (Syphilis). Mandell,G.,Bennett,J.,Dolin.R.(eds.), Principles of Infectious Diseases 4th edition New York,N.Y. 1995;2117-2133
2. American Public Health Assoc. A Manual of Tests for Syphillis. Larsen, S.A., Pope, V., Johnson, R.E., Kennedy Jr., E.J. (eds.), 9th edition, Washington, D.C. 2000.

CPT Codes

86592
LOINC: 31146-4

Contacts

Last Updated

6/16/2021

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