Flood J M, Weinstock H S, Guroy M E, Bayne L, Simon R P, Bolan G
Department of Medicine, University of California, San Francisco, USA.
J Infect Dis. 1998 Apr;177(4):931-40. doi: 10.1086/515245.
To investigate the epidemiology and clinical spectrum of neurosyphilis in a population with high rates of coexisting syphilis and human immunodeficiency virus (HIV) infection, a retrospective analysis of cases in all San Francisco hospitals from 1985 to 1992 was conducted. Neurosyphilis was defined by a newly reactive cerebrospinal fluid VDRL; 117 patients with neurosyphilis were identified. The median age was 39 years, 91% were male, 74 (63%) were white, and 75 (64%) were HIV-infected. Thirty-eight (33%) presented with an early symptomatic neurosyphilis syndrome. Six (5%) had late neurosyphilis. Thirty-eight (32%) patients were asymptomatic, and 35 (30%) had findings attributable to coexisting neurologic diseases. Patients demonstrated high serum nontreponemal (VDRL) titers (median, 1:128) at neurosyphilis presentation. In contrast to the findings from the preantibiotic era, neurosyphilis was identified in young patients most often with HIV coinfection, and early symptomatic syndromes were identified more frequently than late neurosyphilis syndromes.
为了调查在梅毒和人类免疫缺陷病毒（HIV）合并感染率较高的人群中神经梅毒的流行病学和临床特征，对1985年至1992年旧金山所有医院的病例进行了回顾性分析。神经梅毒通过新出现反应性的脑脊液性病研究实验室玻片试验（VDRL）来定义；共识别出117例神经梅毒患者。患者的中位年龄为39岁，91%为男性，74例（63%）为白人，75例（64%）感染了HIV。38例（33%）表现为早期有症状的神经梅毒综合征。6例（5%）患有晚期神经梅毒。38例（32%）患者无症状，35例（30%）有与并存神经系统疾病相关的表现。患者在神经梅毒发病时血清非梅毒螺旋体（VDRL）滴度较高（中位值为1:128）。与抗生素时代之前的研究结果相反，神经梅毒最常出现在合并感染HIV的年轻患者中，并且早期有症状综合征的识别频率高于晚期神经梅毒综合征。
