Cited by 491Syphilis Diagnosis and TreatmentInfectious Diseases and TuberculosisBacterial Infections and Vaccines

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Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features.

Marra, Christina M., Maxwell, Clare L., Smith, Stacy L., Lukehart, Sheila A., Rompalo, Anne M., Eaton, Molly, Stoner, Bradley P., Augenbraun, Michael, Barker, David E., Corbett, James J., Zajackowski, Mark, Raines, Charles, Nerad, Judith, Kee, Romina, Barnett, Scott H.·2004·The Journal of Infectious Diseases

DOI 10.1086/381227

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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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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: Marra, Christina M.
Maxwell, Clare L.
Lukehart, Sheila A.
Rompalo, Anne M.
Stoner, Bradley P.
Augenbraun, Michael
Corbett, James J.
Kee, Romina
Barnett, Scott H.
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
DOI: 10.1086/381227
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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Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features.

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