False-Positive VDRL and FTA in Cerebrospinal Fluid

Abstract

A VARIETY of CSF tests have been used in the diagnosis of neurosyphilis. Two of the most widely used are the nontreponemal VDRL and the FTA. Both tests have high specificity, and false-positive reactions are rare. A case of false-positive VDRL and FTA in the CSF occurred in a patient with meningeal carcinomatosis. Report of a Case A 65-year-old man was in good health until about three months before admission, when dizziness, tinnitis, and a tendency to fall developed. A few days before admission, he noted mild left-sided weakness, with subsequent episodes of confusion and urinary incontinence. He was a chronic alcoholic but gave no history of syphilis. On examination he was unkempt, dehydrated, and undernourished. His blood pressure was 120/70 mm Hg, his pulse rate was regular at 80 beats per minute, and his temperature was 36.4 °C. He was alert and oriented to place, time, and person, but