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Neurosyphilis in AIDS patients

Initial CSF VDRL may be negative

Department of Neurology. Albert Einstein College of Medicine, Headache Unit. Montefiore Medical Center, Bronx. NY.

We report 2 HIV-seropositive patients with neurosyphilis whose initial CSF VDRL tests were negative. The CSF VDRL became positive after 12 days of IV penicillin treatment for syphilitic meningitis in the 1st patient. The 2nd patient developed syphilitic polyradiculopathy and a positive CSF VDRL 3 months after treatment with IV penicillin. Serial CSF VDRL determinations may be required in AIDS patients when a diagnosis of neurosyphilis is suspected.

Address correspondence and reprint requests to Dr. Richard H. Lipton, Headache Unit. Montefiore Medical Center. 111 E. 210th Street, Bronx. NY 10467.

Presented in part at the 41st annual meeting of the American Academy of Neurology. Chicago. IL, April 1989.

Received May 18, 1989. Accepted for publication in final form August 25, 1989.