Identification of the factors associated with post-treatment asymptomatic neurosyphilis in HIV-negative patients with serological non-response syphilis: a retrospective study

Weng, Wenjia; Hou, Jun; Song, Bingbing; Zhang, Ming; Zhang, Tong; Gao, Yanqing

doi:10.1177/0956462420965850

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…Jiang et al retrospectively found that HIV-negative syphilis patients with serum TRUST titers ≥1:16 were eight times more susceptible to developing neurosyphilis ( 68 ). Of note, patients with a fourfold decrease in serum RPR titers after treatment are more likely to develop asymptomatic neurosyphilis (ANS), indicating a correlation between ANS and treatment failure ( 69 ).…”

Section: Risk Factors For Neurosyphilis In Hiv-negative Patientsmentioning

confidence: 99%

Neurosyphilis: insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention

Wu,

Ye,

Wang

et al. 2024

Front. Neurol.

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Background and aimInvasion of the central nervous system by Treponema pallidum can occur at any stage of syphilis. In the event that T. pallidum is not cleared promptly, certain individuals may experience progression to neurosyphilis, which manifests as cognitive and behavioral abnormalities, limb paralysis, and potentially fatal outcomes. Early identification or prevention of neurosyphilis is therefore crucial. The aim of this paper is to conduct a critical and narrative review of the latest information focusing exclusively to the pathogenesis and clinical management of neurosyphilis.MethodologyTo compile this review, we have conducted electronic literature searches from the PubMed database relating to neurosyphilis. Priority was given to studies published from the past 10 years (from 2013 to 2023) and other studies if they were of significant importance (from 1985 to 2012), including whole genome sequencing results, cell structure of T. pallidum, history of genotyping, and other related topics. These studies are classic or reflect a developmental process.ResultsNeurosyphilis has garnered global attention, yet susceptibility to and the pathogenesis of this condition remain under investigation. Cerebrospinal fluid examination plays an important role in the diagnosis of neurosyphilis, but lacks the gold standard. Intravenous aqueous crystalline penicillin G continues to be the recommended therapeutic approach for neurosyphilis. Considering its sustained prominence, it is imperative to develop novel public health tactics in order to manage the resurgence of neurosyphilis.ConclusionThis review gives an updated narrative description of neurosyphilis with special emphasis on its pathogenesis, susceptibility, diagnosis, treatment, and prevention.

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Section: Risk Factors For Neurosyphilis In Hiv-negative Patientsmentioning

confidence: 99%

Neurosyphilis: insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention

Wu,

Ye,

Wang

et al. 2024

Front. Neurol.

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“…Macrolideresistant TP with the A2058G mutation is now present in several areas of the USA, Canada, Europe, and China, with a wide range of prevalence (from 16% in Canada, 85% in France and >90% in China) [66][67][68]. PLWH with syphilis should be treated as HIV-uninfected patients, although they may be at increased risk for treatment failure and may be more likely to progress to neurosyphilis [69,70]. Several studies have evaluated enhanced therapy with additional doses of PGB and found no additional benefit [71,72].…”

Section: Treatmentmentioning

confidence: 99%

A 2021 Update on Syphilis: Taking Stock from Pathogenesis to Vaccines

et al. 2021

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In 2021 the scientific community's efforts have been focused on solving the back-breaking challenge of the COVID-19 pandemic, but sexually transmitted infections (STI) are still one of the most common global health problems. Syphilis is a systemic disease caused by the spirochaete Treponema pallidum (TP) and is one of the oldest known diseases. Its incidence has increased in the last few years and syphilis still remains a contemporary plague that continues to afflict millions of people worldwide. Despite research improvements, syphilis pathogenesis is not completely clear; clinical presentation is very heterogeneous and the diagnosis can sometimes be difficult. Furthermore, few therapeutic options are available, and a vaccine has not been found yet. In this review, we describe the most recent evidence concerning the clinical manifestation, diagnosis, treatment and vaccine prospectives for this disease.

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State-of-the-Art Review: Neurosyphilis

Hamill,

Ghanem,

Tuddenham

2023

Clinical Infectious Diseases

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We review key concepts in the diagnosis, treatment, and follow-up of individuals with neurosyphilis. We describe the epidemiology of syphilis in the United States, highlight populations that are markedly affected by this infection, and attempt to estimate the burden of neurosyphilis. We describe the cardinal clinical features of early and late (tertiary) neurosyphilis and characterize the clinical significance of asymptomatic neurosyphilis in the antibiotic era. We review the indications for cerebrospinal fluid (CSF) examination and the performance characteristics of different CSF assays including treponemal and lipoidal antibodies, white cell count, and protein concentration. Future biomarkers and the role of imaging are briefly considered. We review preferred and alternative treatments for neurosyphilis and evidence for their use, including evidence for the use of enhanced intramuscular benzathine penicillin G to supplement intravenous penicillin.

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Identification of the factors associated with post-treatment asymptomatic neurosyphilis in HIV-negative patients with serological non-response syphilis: a retrospective study

Cited by 5 publications

References 19 publications

Neurosyphilis: insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention

Neurosyphilis: insights into its pathogenesis, susceptibility, diagnosis, treatment, and prevention

A 2021 Update on Syphilis: Taking Stock from Pathogenesis to Vaccines

State-of-the-Art Review: Neurosyphilis

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