![]() ![]() Meningovascular NS is defined as endarteritis of central nervous system (CNS) vessels, and parenchymatous late NS as general paresis and tabes dorsalis. Early NS is defined as symptoms of meningitis or ocular symptoms with positive serological results within 12 months of infection. Neurosyphilis (NS) has multiple clinical presentations, and there is no consensus concerning its definition. (See the Editorial Commentary by Musher on pages 1187–8.) PCR is highly specific and of potential value when used with other biological parameters. The nested PCR assay had an overall sensitivity of 42.5%, a specificity of 97%, a positive predictive value of 77%, and a negative predictive value of 86%.Ĭonclusions. Early NS is the most frequent presentation, with an overrepresentation of polymorphous ophthalmological symptoms. CSF PCR results were positive in 42%, and CSF VDRL results in 30%. Seventeen patients (42.5%) had CSF white blood cell counts >20/μL (mean, 57/μL), and 27 (67.5%) had high CSF protein levels (>0.5 g/L mean value, 1 g/L). ![]() Ophthalmological symptoms were present in 65% of all patients with NS, and neurological symptoms in 60%. All patients with late NS had neurological symptoms, and 2 (40%) also had ocular symptoms. All patients with meningovascular NS had only neurological symptoms. Twenty-four patients (80%) with early NS had ophthalmological symptoms, 14 (47%) had neurological symptoms, and 8 (26%) had both. Results. Thirty patients (75%) had early, 5 (12.5%) had late, and 5 had meningovascular NS. Methods. From 2001 to 2013, we included 40 patients (90% men 45% infected with human immunodeficiency virus) with NS, defined as syphilis with neurological and/or ophthalmological symptoms and CSF abnormalities. We conducted a prospective study to define more precisely the clinical and biological characteristics of patients with neurosyphilis (NS), and we assessed the diagnostic value of nested polymerase chain reaction (PCR) testing for Treponema pallidum in cerebrospinal fluid (CSF) samples. Clélia Vanhaecke, Philippe Grange, Nadjet Benhaddou, Philippe Blanche, Dominique Salmon, Perrine Parize, Olivier Lortholary, Eric Caumes, Isabelle Pelloux, Olivier Epaulard, Jérôme Guinard, Nicolas Dupin, the Neurosyphilis network, Sophie Galimard, Timothée Boyer Chammard, Benoit Henry, Loïc Epelboin, Neila Sedira, Emmanuel Heron, Isabelle Alcaraz, Nathalie Franck, Hélène Chaussade, Adrien Lemaignen, Claire Demangeot, Antoine Petit, Magdalena Gerin, Christophe Guier, Nadia Idri, Bertrand Issartel, Etienne Lagier, Anne Léger, Isabelle Mahé, Emmanuel Mortier, Eric Monlun, Christophe Rapp, Claude Remy, Laurent Renier, Olivier Saladini, François Sellal, Valérie Serry, Laurence Weiss, on behalf of the Neurosyphilis Network, Clinical and Biological Characteristics of 40 Patients With Neurosyphilis and Evaluation of Treponema pallidum Nested Polymerase Chain Reaction in Cerebrospinal Fluid Samples, Clinical Infectious Diseases, Volume 63, Issue 9, 1 November 2016, Pages 1180–1186, īackground. Syphilis remains a significant public health problem. ![]()
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