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Predictive value of neurological symptoms in persons with suspected neurosyphilis
  1. Fareed Shiva1,
  2. Charlotte-Eve Short1,
  3. David Goldmeier1,
  4. Alan Winston2
  1. 1 Department of Genitourinary Medicine and HIV, Imperial College Healthcare NHS Trust, London, UK
  2. 2 Department of Medicine, Imperial College London, London, UK
  1. Correspondence to Dr Fareed Shiva, Department of Genitourinary Medicine, St Mary's Hospital, London W2 1NY, UK; fareed.shiva{at}

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Treponema pallidum is detected in the cerebrospinal fluid (CSF) in up to 30% of individuals with early syphilis.1 An ongoing challenge in accurate diagnoses of neurosyphilis (NS) is variable symptomatology at presentation. Often, individuals with reactive syphilis serology and neurological symptoms are empirically treated for neurosyphilis.

We previously described the utility of CSF Treponema Pallidum Particle Agglutination (TPPA) titres in the diagnosis of NS.2 Here, we assess the utility of presenting neurological symptoms in the diagnosis of NS.

Data on individuals whom a diagnosis of NS was being considered and a CSF examination undertaken, between January 2017 and November 2020, were gathered and included presenting symptoms and serum rapid plasma reagin (RPR) concentration. …

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  • Handling editor Anna Maria Geretti

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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