Symptomatic neurosyphilis in HIV-negative patients: a retrospective cohort study
IntroductionNeurosyphilis does not necessarily involve progressive invasion from interstitial to parenchymal nerve tissue. Few studies have focused on human immunodeficiency virus (HIV)-negative patients with symptomatic neurosyphilis, and the clinical outcomes and factors influencing the outcomes a...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-02-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1505818/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832539912085176320 |
|---|---|
| author | Qiaoer Chen Qiaoer Chen Weiqi Wu Lu Wang Honghong Huang Lingxing Wang |
| author_facet | Qiaoer Chen Qiaoer Chen Weiqi Wu Lu Wang Honghong Huang Lingxing Wang |
| author_sort | Qiaoer Chen |
| collection | DOAJ |
| description | IntroductionNeurosyphilis does not necessarily involve progressive invasion from interstitial to parenchymal nerve tissue. Few studies have focused on human immunodeficiency virus (HIV)-negative patients with symptomatic neurosyphilis, and the clinical outcomes and factors influencing the outcomes are unclear. Therefore, in this study, we aimed to compare the characteristics and clinical outcomes of interstitial and parenchymal neurosyphilis following treatment in HIV-negative patients with symptomatic neurosyphilis.MethodsWe conducted a retrospective analysis of the clinical characteristics, laboratory results, neuroimaging findings, treatment regimens, and outcomes at discharge of HIV-negative patients admitted to our hospital with symptomatic neurosyphilis between May 2013 and May 2023.ResultsOf the 142 patients, the mean age was 56.6 ± 11.4 years, with 111 (78.2%) being men. The predominant clinical manifestations included psychological disorders, cognitive decline, and cranial nerve disorders. Overall, 134 (94.4%) patients had elevated cerebrospinal fluid (CSF) cell counts, 113 (79.6%) had elevated protein levels, and 22/133 (16.5%) had elevated intracranial pressure. During hospitalization 113 patients (87.6%) were treated with intravenous penicillin and 13 (10.1%) were treated with ceftriaxone. Furthermore, 62 (43.7%) and 80 (56.3%) patients had interstitial and parenchymal types of neurosyphilis, respectively. Patients with the parenchymal type were younger and had higher platelet-to-lymphocyte ratio (PLR) and lower lymphocyte-to-monocyte ratio (LMR). Overall, 126 (88.7%) patients completed anti-syphilitic treatment prior to discharge, with 111 (88.1%) showing poor outcomes.DiscussionAn elevated CSF protein level and the parenchymal type were associated with poor outcome. This study revealed that clinical manifestations of neurosyphilis vary, and that the majority of patients had elevated CSF cell and protein levels and a normal intracranial pressure. The PLR was higher and the LMR was lower in the parenchymal type than in the interstitial type. Only a small proportion of patients had favorable outcomes. CSF protein level and parenchymal type may be risk factors for poor prognosis. |
| format | Article |
| id | doaj-art-8e14c1a9d32e46d790364b5934c7e2a0 |
| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-8e14c1a9d32e46d790364b5934c7e2a02025-02-05T07:32:08ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-02-011310.3389/fpubh.2025.15058181505818Symptomatic neurosyphilis in HIV-negative patients: a retrospective cohort studyQiaoer Chen0Qiaoer Chen1Weiqi Wu2Lu Wang3Honghong Huang4Lingxing Wang5Department of Neurology, Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, ChinaDepartment of Neurology, The Second Hospital of Longyan, Longyan, Fujian, ChinaDepartment of Neurology, Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, ChinaDepartment of Neurology, Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, ChinaDepartment of Neurology, Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, ChinaDepartment of Neurology, Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, ChinaIntroductionNeurosyphilis does not necessarily involve progressive invasion from interstitial to parenchymal nerve tissue. Few studies have focused on human immunodeficiency virus (HIV)-negative patients with symptomatic neurosyphilis, and the clinical outcomes and factors influencing the outcomes are unclear. Therefore, in this study, we aimed to compare the characteristics and clinical outcomes of interstitial and parenchymal neurosyphilis following treatment in HIV-negative patients with symptomatic neurosyphilis.MethodsWe conducted a retrospective analysis of the clinical characteristics, laboratory results, neuroimaging findings, treatment regimens, and outcomes at discharge of HIV-negative patients admitted to our hospital with symptomatic neurosyphilis between May 2013 and May 2023.ResultsOf the 142 patients, the mean age was 56.6 ± 11.4 years, with 111 (78.2%) being men. The predominant clinical manifestations included psychological disorders, cognitive decline, and cranial nerve disorders. Overall, 134 (94.4%) patients had elevated cerebrospinal fluid (CSF) cell counts, 113 (79.6%) had elevated protein levels, and 22/133 (16.5%) had elevated intracranial pressure. During hospitalization 113 patients (87.6%) were treated with intravenous penicillin and 13 (10.1%) were treated with ceftriaxone. Furthermore, 62 (43.7%) and 80 (56.3%) patients had interstitial and parenchymal types of neurosyphilis, respectively. Patients with the parenchymal type were younger and had higher platelet-to-lymphocyte ratio (PLR) and lower lymphocyte-to-monocyte ratio (LMR). Overall, 126 (88.7%) patients completed anti-syphilitic treatment prior to discharge, with 111 (88.1%) showing poor outcomes.DiscussionAn elevated CSF protein level and the parenchymal type were associated with poor outcome. This study revealed that clinical manifestations of neurosyphilis vary, and that the majority of patients had elevated CSF cell and protein levels and a normal intracranial pressure. The PLR was higher and the LMR was lower in the parenchymal type than in the interstitial type. Only a small proportion of patients had favorable outcomes. CSF protein level and parenchymal type may be risk factors for poor prognosis.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1505818/fullneurosyphilisTreponema pallidumHIV-negative individualsinterstitial neurosyphilisparenchymal neurosyphilis |
| spellingShingle | Qiaoer Chen Qiaoer Chen Weiqi Wu Lu Wang Honghong Huang Lingxing Wang Symptomatic neurosyphilis in HIV-negative patients: a retrospective cohort study Frontiers in Public Health neurosyphilis Treponema pallidum HIV-negative individuals interstitial neurosyphilis parenchymal neurosyphilis |
| title | Symptomatic neurosyphilis in HIV-negative patients: a retrospective cohort study |
| title_full | Symptomatic neurosyphilis in HIV-negative patients: a retrospective cohort study |
| title_fullStr | Symptomatic neurosyphilis in HIV-negative patients: a retrospective cohort study |
| title_full_unstemmed | Symptomatic neurosyphilis in HIV-negative patients: a retrospective cohort study |
| title_short | Symptomatic neurosyphilis in HIV-negative patients: a retrospective cohort study |
| title_sort | symptomatic neurosyphilis in hiv negative patients a retrospective cohort study |
| topic | neurosyphilis Treponema pallidum HIV-negative individuals interstitial neurosyphilis parenchymal neurosyphilis |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1505818/full |
| work_keys_str_mv | AT qiaoerchen symptomaticneurosyphilisinhivnegativepatientsaretrospectivecohortstudy AT qiaoerchen symptomaticneurosyphilisinhivnegativepatientsaretrospectivecohortstudy AT weiqiwu symptomaticneurosyphilisinhivnegativepatientsaretrospectivecohortstudy AT luwang symptomaticneurosyphilisinhivnegativepatientsaretrospectivecohortstudy AT honghonghuang symptomaticneurosyphilisinhivnegativepatientsaretrospectivecohortstudy AT lingxingwang symptomaticneurosyphilisinhivnegativepatientsaretrospectivecohortstudy |