Neurosyphilis in acquired immunodeficiency syndrome

D. A. Katz and J. R. Berger
Department of Neurology, University of Miami, School of Medicine, FL 33136.

In a retrospective study encompassing 42 months (January 1984 through July 1987), 12 patients were identified as having both neurosyphilis and acquired immunodeficiency syndrome. These patients constituted 44% of the entire group meeting rigorous diagnostic criteria for neurosyphilis and 1.5% of all patients hospitalized with acquired immunodeficiency syndrome. The typical patient with acquired immunodeficiency syndrome and neurosyphilis was young (mean age, 37 years) and male (83%). All had serological evidence 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 previously treated for syphilis. In 2, treatment for latent syphilis had been completed 3 and 5 months, respectively, before neurosyphilis was documented. Neurosyphilis is not uncommon in patients with acquired immunodeficiency syndrome in our population. In light of its diverse manifestations, syphilis should be considered in the differential diagnosis of any human immunodeficiency virus type 1-infected individual presenting with neurological, psychiatric, or ophthalmological disease.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Symptomatic Early Neurosyphilis Among HIV-Positive Men Who Have Sex With Men Four Cities, United States, January 2002 June 2004
JAMA 2007;298:732-734.
FULL TEXT  

Molecular typing of Treponema pallidum strains from patients with neurosyphilis in Pretoria, South Africa
Molepo et al.
Sex. Transm. Infect. 2007;83:189-192.
ABSTRACT | FULL TEXT  

Neurosyphilis in the modern era
Timmermans and Carr
J. Neurol. Neurosurg. Psychiatry 2004;75:1727-1730.
ABSTRACT | FULL TEXT  

Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features
Singh and Romanowski
Clin. Microbiol. Rev. 1999;12:187-209.
ABSTRACT | FULL TEXT  

Treatment of Early Syphilis
Fantry et al.
NEJM 1997;337:1697-1698.
FULL TEXT  

The Response of Symptomatic Neurosyphilis to High-Dose Intravenous Penicillin G in Patients with Human Immunodeficiency Virus Infection
Gordon et al.
NEJM 1994;331:1469-1473.
ABSTRACT | FULL TEXT  

The Management of Central Nervous System Infections
Zabinski et al.
Journal of Pharmacy Practice 1991;4:170-191.