title: Usefulness of routine lumbar puncture in non-HIV patients with latent syphilis of unknown duration.
abstract: OBJECTIVE
  To evaluate the usefulness of routine lumbar puncture in non-HIV patients with untreated latent syphilis.
  
  
  METHODS
  We conducted a prospective study in Seoul National University Bundang Hospital from May 2003 to December 2005. Participants in routine health check-ups of the healthcare system were screened for serological evidence of syphilis by the Treponema pallidum particle agglutination (TPPA) test. Lumbar puncture was performed, with consent, on untreated latent syphilitic patients. Neurosyphilis was defined as positivity for cerebrospinal fluid Venereal Disease Research Laboratory (CSF VDRL) or pleocytosis with positivity for CSF TPPA or elevation of CSF protein with IgG index exceeding 0.85.
  
  
  RESULTS
  Of 21 507 participants, 282 (1.4%) had serological evidence of syphilis. 117 (41%) of these had a history of syphilis treatment and 2 were seropositive for HIV. Among the 163 non-HIV patients with untreated latent syphilis, 70 (43%) underwent lumbar puncture. All the patients had VDRL titres less than 1:16. Abnormal neurological signs or symptoms were present in eight (11%) patients. CSF abnormalities were seen in 57 (81%), but no patient (0%, 95% CI 0 to 6.2) was diagnosed with neurosyphilis.
  
  
  CONCLUSIONS
  The estimated prevalence of neurosyphilis among non-HIV patients with untreated latent syphilis and serum VDRL <1:16, was below 6.2%.
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Gumi-ro 166, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
authors.forename: Pyoeng Gyun
authors.initials: PG
authors.lastname: Choe
authors.forename: Jin Su
authors.initials: JS
authors.lastname: Song
authors.forename: Kyoung-Ho
authors.initials: KH
authors.lastname: Song
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Jeon
authors.forename: Wan Beom
authors.initials: WB
authors.lastname: Park
authors.forename: Kyoung Un
authors.initials: KU
authors.lastname: Park
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Park
authors.forename: Nam Joong
authors.initials: NJ
authors.lastname: Kim
authors.forename: Myoung-don
authors.initials: MD
authors.lastname: Oh
authors.forename: Hong Bin
authors.initials: HB
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000134:cerebrospinal fluid; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D018023:HIV Seronegativity; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D007964:Leukocytosis / Q000175:diagnosis; D008875:Middle Aged; D009494:Neurosyphilis / Q000175:diagnosis*; D018579:Patient Selection; D011446:Prospective Studies; D013129:Spinal Puncture; D013592:Syphilis, Latent / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D002556:Cerebrospinal Fluid Proteins; D007074:Immunoglobulin G