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The utility of cerebrospinal fluid analysis in the investigation and treatment of neurosyphilis
  1. Mariana Noy,
  2. Michael Rayment,
  3. Ann Sullivan,
  4. Mark Nelson
  1. Directorate of Genito-urinary and HIV Medicine, Chelsea and Westminster Hospital, London, UK
  1. Correspondence to Dr Mariana Noy, Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK; mariana.noy{at}

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British Society for Sexual Health and HIV guidelines detail indications for, and interpretation of, cerebrospinal fluid (CSF) examination in those diagnosed serologically with syphilis.1 These include neurological signs or symptoms, or in those who have failed to respond to treatment.1

CSF syphilis results should be interpreted in conjunction with clinical features, and most with symptomatic neurosyphilis will demonstrate a CSF pleocytosis.1 Difficulties in the diagnosis of neurosyphilis occur as no single test has high specificity and sensitivity.2 In view of these …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.