Neurosyphilis in Acquired Immunodeficiency Syndrome

doi:10.1001/archneur.1989.00520440085024

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Vol. 46 No. 8, August 1989

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Neurosyphilis in Acquired Immunodeficiency Syndrome

Debra A. Katz, MD; Joseph R. Berger, MD

Arch Neurol. 1989;46(8):895-898.

Abstract

• In a retrospective study encompassing 42 months (January1984 through July 1987), 12 patients were identified as havingboth neurosyphilis and acquired immunodeficiency syndrome. Thesepatients constituted 44% of the entire group meeting rigorousdiagnostic criteria for neurosyphilis and 1.5% of all patientshospitalized with acquired immunodeficiency syndrome. The typicalpatient with acquired immunodeficiency syndrome and neurosyphiliswas young (mean age, 37 years) and male (83%). All had serologicalevidence of syphilis in both blood and cerebrospinal fluid.Syphilitic eye disease was surprisingly common in this group,occurring in 5 (42%). Four patients (33%) had been previouslytreated for syphilis. In 2, treatment for latent syphilis hadbeen completed 3 and 5 months, respectively, before neurosyphiliswas documented. Neurosyphilis is not uncommon in patients withacquired immunodeficiency syndrome in our population. In lightof its diverse manifestations, syphilis should be consideredin the differential diagnosis of any human immunodeficiencyvirus type 1—infected individual presenting with neurological,psychiatric, or ophthalmological disease.

Author Affiliations

From the Departments of Neurology (Drs Katz and Berger), Pediatrics (Dr Katz), and Internal Medicine (Dr Berger), University of Miami (Fla) School of Medicine.

Footnotes

Accepted for publication February 6, 1989.

Reprint requests to Department of Neurology, University of MiamiSchool of Medicine, 1501 NW Ninth Ave, Miami, FL 33136 (Dr Berger).

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