Abstract

Initial syphilis infection results in CNS invasion by the spirochete Treponema pallidum in approximately 25–30% of cases. Spontaneous CNS clearance can occur, and most patients do not develop neurosyphilis. However, neurosyphilis may be more commonly diagnosed in patients who are co-infected with HIV. There is currently no highly sensitive and specific laboratory test for neurosyphilis, so diagnosis must be made on the basis of clinical suspicion and interpretation of the patient’s epidemiologic profile, medical history, physical (including neurologic) examination and laboratory test results. This review aims to provide a summary of the salient epidemiologic and clinical features of neurosyphilis, as well as important points in its diagnosis, treatment and management.

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