The DOI matches its Crossref record; 27 of the 27 references it cites were found in a registry or an index.
Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features.
Abstract
OBJECTIVE: To define clinical and laboratory features that identify patients with neurosyphilis. METHODS: Subjects (n=326) with syphilis but no previous neurosyphilis who met 1993 Centers for Disease Control and Prevention criteria for lumbar puncture underwent standardized history, neurological examination, venipuncture, and lumbar puncture. Neurosyphilis was defined as a cerebrospinal fluid (CSF) white blood cell count >20 cells/ microL or reactive CSF Venereal Disease Research Laboratory (VDRL) test result. RESULTS: Sixty-five subjects (20.1%) had neurosyphilis. Early syphilis increased the odds of neurosyphilis in univariate but not multivariate analyses. In multivariate analyses, serum rapid plasma reagin (RPR) titer > or =1 : 32 increased the odds of neurosyphilis 10.85-fold in human immunodeficiency virus (HIV)-uninfected subjects and 5.98-fold in HIV-infected subjects. A peripheral blood CD4+ T cell count < or =350 cells/ microL conferred 3.10-fold increased odds of neurosyphilis in HIV-infected subjects. Similar results were obtained when neurosyphilis was more stringently defined as a reactive CSF VDRL test result. CONCLUSION: Serum RPR titer helps predict the likelihood of neurosyphilis. HIV-induced immune impairment may increase the risk of neurosyphilis.
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“Limited data indicate that changes in CSF parameters might occur more slowly among persons with HIV infection, especially those with more advanced immunosuppression (588,624).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [588]
In the citing paper
“a serum RPR titre of 1:32 has been demonstrated to be associated with CSF abnormalities similar to those seen in neurosyphilis.63,65”
From BASHH UK guidelines for the management of syphilis 2024 (2024) · cites this paper as [63]
In the citing paper
“CSF examination is indicated when there is clinical evidence of neurological involvement, except for ophthalmic or otological syphilis where it is rarely useful, irrespective of stage of disease62,63: 1C.”
From BASHH UK guidelines for the management of syphilis 2024 (2024) · cites this paper as [63]
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Self-citation
Metadata
- Authors
- Marra, C. M., Maxwell, C. L., Smith, S. L., Lukehart, S. A., Rompalo, A. M., Eaton, M., Stoner, B. P., Augenbraun, M., Barker, D. E., Corbett, J. J., Zajackowski, M., Raines, C., Nerad, J., Kee, R., & Barnett, S. H.
- Affiliations
- University of Washington (US)
- Johns Hopkins University (US)
- Emory University (US)
- Washington University in St. Louis (US)
- SUNY Downstate Health Sciences University (US)
- John H. Stroger, Jr. Hospital of Cook County (US)
- University of Mississippi (US)
- Chicago Department of Public Health (US)
- ORCID
- Venue
- The Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-02
- Volume
- 189
- Issue
- 3
- Pages
- 369-376
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- OpenAlex
- W2168374971
- Cited by
- 491
- References
- 27
- Citations by year
- 2026: 13 · 2025: 13 · 2024: 21 · 2023: 24 · 2022: 18 · 2021: 31 · 2020: 29 · 2019: 20 · 2018: 19 · 2017: 21 · 2016: 18 · 2015: 29 · 2014: 29 · 2013: 25 · 2012: 26
- FWCI
- 11.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Washington
- National Institutes of Health
- National Institute of Neurological Disorders and Stroke (NS 34235, R01NS034235)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Syphilis Diagnosis and Treatment
- Health Sciences › Medicine › Infectious Diseases › Infectious Diseases and Tuberculosis
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Keywords
- neurosyphilis, cerebrospinal fluid abnormalities, syphilis, HIV infection, CD4 count, CSF white blood cell count, early syphilis, risk factors
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Neurosyphilis, Reagins, Risk Factors, Syphilis, Treponema pallidum, HIV Infections, Multivariate Analysis, CD4 Lymphocyte Count
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