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What is the mandatory diagnostic test for congenital syphilis in infants?

  1. CSF VDRL

  2. Fluorescent treponemal antibody absorption

  3. Serum VDRL

  4. Blood culture

The correct answer is: CSF VDRL

The mandatory diagnostic test for congenital syphilis in infants is the CSF VDRL (Cerebrospinal Fluid Venereal Disease Research Laboratory test). This test is critical because it directly assesses the presence of syphilis in the central nervous system, which can be affected in cases of congenital syphilis. Infants born to mothers with untreated syphilis are at risk for a range of complications, including neurological involvement. Testing using CSF VDRL is particularly important in cases where there are signs of neurological disease, even if there are no clinical symptoms. A positive CSF VDRL indicates that the infection has crossed the blood-brain barrier, which is a significant concern in the clinical management of these infants. If confirmed, further treatment options can be considered to prevent long-term complications. Other potential tests like the Fluorescent Treponemal Antibody Absorption test or Serum VDRL may provide valuable information about the presence of syphilis but do not specifically evaluate CNS involvement. Blood culture is not routinely used for diagnosing congenital syphilis. Therefore, the CSF VDRL is the most appropriate and widely accepted test in the context of congenital syphilis in infants, highlighting its necessity in clinical practice.