ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
How Well Do Neurologic Symptoms Identify Individuals With Neurosyphilis?
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Management of Adult Syphilis: Key Questions to Inform the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Pooled it
- Diagnostic tools for neurosyphilis: a systematic review.BMC infectious diseases · 2021Pooled it
- The prevalence of asymptomatic neurosyphilis among HIV-negative serofast patients in China: A meta-analysis.PloS one · 2020Pooled it
- Cognitive impairment in syphilis: Does treatment based on cerebrospinal fluid analysis improve outcome?PloS one · 2021Trial
- Community and Hospital HIV Follow-Up Clinics Achieve Similar Lumbar Puncture and Syphilis Treatment Success in Patients with HIV-Syphilis Coinfection: Saskatoon, SK, Canada.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2025Article
- Epigenetic Changes in Cerebrospinal Fluid and Blood of People With Neurosyphilis.The Journal of infectious diseases · 2025Article
- Evaluation of cerebrospinal fluid treponema pallidum particle agglutination assay titer for neurosyphilis diagnosis among HIV-negative syphilis patients.Frontiers in immunology · 2025Article
- Neurosyphilis is characterized by a compartmentalized and robust neuroimmune response but not by neuronal injury.Med (New York, N.Y.) · 2024Article
- Neurosyphilis mimicking giant cell arteritis both clinically and microscopically.BMJ case reports · 2022Article
- Development and external validation of a nomogram for neurosyphilis diagnosis among non-HIV patients: a cross-sectional study.BMC neurology · 2021Article
- Prevalence of Self-reported Neurologic and Ocular Symptoms in Early Syphilis Cases.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Elevation of Cerebrospinal Fluid Light and Heavy Neurofilament Levels in Symptomatic Neurosyphilis.Sexually transmitted diseases · 2020Article
- Neurosyphilis Treatment Outcomes After Intravenous Penicillin G Versus Intramuscular Procaine Penicillin Plus Oral Probenecid.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Otosyphilis: A Review of the Literature.Sexually transmitted diseases · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
Background: Current guidelines recommend lumbar puncture (LP) in patients with syphilis who have neurologic symptoms. Methods: A total of 81 human immunodeficiency virus (HIV)-uninfected individuals and 385 HIV-infected individuals enrolled in a study of cerebrospinal fluid (CSF) abnormalities in syphilis underwent LP and a structured symptom history, including assessment of headache; stiff neck; photophobia; ocular inflammation; vision, hearing, or sensory loss; or gait incoordination. Neurosyphilis was defined as a reactive CSF-Venereal Disease Research Laboratory (VDRL) test. Association between categorical variables was assessed using χ2, Fisher exact test, or logistic regression. Association between continuous and categorical variables was assessed using Mann-Whitney U test. Results: CSF-VDRL was reactive in 20 (24.7%) HIV-uninfected and 68 (17.7%) HIV-infected (P = .14) individuals. No symptom was more common in HIV-uninfected individuals with neurosyphilis. Among the HIV-infected, the odds of a reactive CSF-VDRL were higher in those with mild or greater severity photophobia (2.0 [95% confidence interval [CI], 1.1-3.8]; P = .03), vision loss (2.3 [1.3-4.1]; P = .003), or gait incoordination (2.4 [1.3-4.4]; P = .006); or moderate or greater severity hearing loss (3.1 [1.3-7.5]; P = .01). Diagnostic specificity of these 4 symptoms for neurosyphilis was high when limited to moderate or greater severity (91.6%-100%); however, the diagnostic sensitivity was low (1.5%-38.1%). Conclusions: Among HIV-infected patients with syphilis, 4 specific neurologic symptoms are more common in those with a reactive CSF-VDRL. Lack of symptoms does not guarantee that the CSF-VDRL is nonreactive, regardless of HIV status.
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