Neurosyphilis: Diagnosis and Response to Treatment

摘要

In this issue of Clinical Infectious Diseases, an important article examines the sero-logical response to treatment of neurosyphilis. Marra et al. show that normalization of the results of the serum antibody test for cardiolipin (rapid plasma reagin [RPR]) is a strong indicator of success after treatment of neurosyphilis. Most of their patients had HIV infection, but their findings are likely to apply to HIV-uninfected persons, as well.This article provides great practical help to physicians who treat patients for sexually transmitted diseases. Performing a lumbar puncture in a clinical setting is logistically difficult, and furthermore, patients often refuse it. Thus, it is reassuring to learn that normalization of the serum RPR titer is highly predictive of a good response to therapy, even though this finding is somewhat less likely to apply to untreated patients with AIDS.