06/06/2002 By Anne MacLennan
Central nervous system involvement is common in infants infected with Treponema pallidum and, although most can be identified conventionally, IgM immunoblotting and PCR assay are needed to be sure all infected babies are identified.
Neurosyphilis is believed to occur in 60 percent of infants with congenital syphilis as determined by such cerebrospinal fluid abnormalities as reactivity on a Venereal Disease Research Laboratory (VDRL) test, pleocytosis and elevated protein content.
Until now, however, because this approach has not been validated by rabbit-infectivity testing, it has been unknown whether results based on these criteria are accurate.
Ian C. Michelow and colleagues from the University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States, used rabbit-infectivity testing of cerebrospinal fluid to detect T pallidum infection of the central nervous system (CNS) in infants of mothers with syphilis.
Results were then compared with those of clinical, radiographic and conventional laboratory evaluations; IgM immunoblotting of serum and cerebrospinal fluid; polymerase-chain-reaction (PCR) assay testing of serum or blood and cerebrospinal fluid and rabbit-infectivity testing of serum or blood.
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