Neurosyphilis may be asymptomatic, with findings only on examination of cerebrospinal fluid. The usual findings on exam of CSF are presence of white blood cells, elevated protein, and a reactive serologic test for syphilis (the VDRL is generally accepted as the standard test for CSF). It is vital to understand that, in the presence of HIV infection, neurosyphilis in any of its manifestations may become apparent within weeks to months of primary syphilitic infection.