神经梅毒
医学
梅毒
青霉素
无症状的
抗生素
脑脊液
密螺旋体病
流行病学
重症监护医学
儿科
免疫学
内科学
性传播疾病
微生物学
人类免疫缺陷病毒(HIV)
生物
作者
Matthew M. Hamill,Khalil G. Ghanem,Susan Tuddenham
摘要
Abstract We review key concepts in the diagnosis, treatment, and follow-up of individuals with neurosyphilis. We describe the epidemiology of syphilis in the United States, highlight populations that are markedly affected by this infection, and attempt to estimate the burden of neurosyphilis. We describe the cardinal clinical features of early and late (tertiary) neurosyphilis and characterize the clinical significance of asymptomatic neurosyphilis in the antibiotic era. We review the indications for cerebrospinal fluid (CSF) examination and the performance characteristics of different CSF assays including treponemal and lipoidal antibodies, white cell count, and protein concentration. Future biomarkers and the role of imaging are briefly considered. We review preferred and alternative treatments for neurosyphilis and evidence for their use, including evidence for the use of enhanced intramuscular benzathine penicillin G to supplement intravenous penicillin.
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