Clinical features and treatment of neurosyphilis in a public hospital, Callao, 1997-2007.

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Clinical features and treatment of neurosyphilis in a public hospital, Callao, 1997-2007.

Journal Title: Revista Peruana de Medicina Experimental y Salud Publica - Year 2008, Vol 25, Issue 4

Abstract

[i][b]Objectives.[/b][/i] To describe clinical features, cerebrospinal fluid (CSF) changes, and therapy of patients with neurosyphilis (NS). [b][i]Material and methods. [/i][/b]This is a retrospective study including patients older than 14 years who met criteria for defining a confirmed or probable case of neurosyphilis according to the Centers for Disease Control and Prevention (CDC) and who were admitted to a public hospital in Callao, Peru, between 1997 and 2007. [b][i]Results. [/i][/b]Twenty-five patients met criteria for defining NS (22 for confirmed cases and 3 for probable cases). Median age was 40 years, 24 patients (96%) were men, four (16%) had a past history of syphilis, and 15 (60%) had HIV infection. Twenty-one patients (84%) developed symptomatic NS, of which fourteen (67%) had early forms, and this pattern was most commonly seen in HIV-infected patients (p=0.001). Of those patients with CSF data available, 64% (14/22) had pleocytosis and 73% (16/22) high protein levels, and there were no significant differences between patients with and without HIV infection. CSF VDRL tests were reported as reactive in 88% (22/25) of patients. Median CSF VDRL titers were lower in HIV-infected patients (p=0.006), and a higher proportion of HIV-negative patients had CSF VDRL titers ≥1:4 (p=0.02). 72% of patients received high-dose intravenous aqueous crystalline penicillin G. [b][i]Conclusions. [/i][/b]The majority of patients with NS had HIV infection. Early NS was more common than late NS and the CSF VDRL titers were lower in HIV-infected patients. High-dose intravenous penicillin was the most frequently used therapy.

Authors and Affiliations

Walter De la Cruz, Maria Castañeda

Keywords

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