Significance of the Treponema pallidum immobilization test on spinal fluid.

Abstract

• The Treponema pallidum immobilization test on the blood, barring laboratory error and excluding other treponematoses, gives results that, in the opinion of the authors, need no longer be questioned. The same test can be done on the spinal fluid, and 376 specimens from 324 patients were examined in this way. Levels of immobilizing antibody were in general significantly lower in the spinal fluid than in the blood. Negative results on spinal fluid were obtained in 14 out of 100 undoubted cases of neurosyphilis; hence negative immobilization tests do not exclude the diagnosis of neurosyphilis. Positive results on spinal fluid were not found except in the presence of other convincing evidence of neurosyphilis; they are therefore diagnostic. The test should be done when the specimen is fresh; after refrigeration and storage, some initially positive specimens became negative.