{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T22:50:06Z","timestamp":1761519006509,"version":"build-2065373602"},"reference-count":34,"publisher":"CSIRO Publishing","issue":"2","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":5217,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,5,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The rise in serious complications of early syphilis, including neurosyphilis, particularly in those with HIV infection and in men who have sex with men (MSM), is of concern. Objectives: To review the manifestations and management of neurosyphilis in a population of HIV-infected MSM. Methods: Retrospective review of patients with HIV and early neurosyphilis in three centres in Melbourne, Australia, in 2000\u201307. Results: Eighteen male HIV patients met the criteria for diagnosis of early neurosyphilis. Thirteen patients (72.2%) had neurological symptoms: six with headache (33.3%), four with tinnitus (22.2%) and five with impaired vision (27.8%), and one patient each with ataxia, leg weakness and anal discharge with faecal incontinence. Five patients (27.8%) reported no neurological symptoms. All had serum rapid plasma reagin (RPR) titres \u22651 : 32 and all except one had cerebrospinal fluid positive for syphilis fluorescent treponemal antibodies-absorbed. After treatment with 14\u201315 days of 1.8 g intravenous benzylpenicillin 4-hourly, 12 of 17 patients (71%) demonstrated a four-fold drop in serum RPR titre over 6\u201312 months and were considered successfully treated. A rise in RPR was noted in three patients during the 12-month follow-up period, suggesting re-infection or recurrence. Conclusion: HIV-infected patients found to have syphilis either because of symptoms or by routine screening should be carefully assessed for neurological, ophthalmic and otological symptoms and signs. A low threshold for a diagnostic lumbar puncture to exclude the diagnosis of neurosyphilis enables appropriate administration and dose of penicillin for treatment, which appears successful in ~75% of cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh10060","type":"journal-article","created":{"date-parts":[[2011,6,22]],"date-time":"2011-06-22T03:49:14Z","timestamp":1308714554000},"page":"207-213","source":"Crossref","is-referenced-by-count":16,"title":["Symptomatic and asymptomatic early neurosyphilis in HIV-infected men who have sex with men: a retrospective case series from 2000 to 2007"],"prefix":"10.1071","volume":"8","author":[{"given":"Christina C.","family":"Chang","sequence":"first","affiliation":[{"name":"AInfectious Diseases Unit, The Alfred Hospital and Department of Medicine, Monash University, Vic. 3004, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David E.","family":"Leslie","sequence":"additional","affiliation":[{"name":"BVictorian Infectious Diseases Reference Laboratory, Carlton South, Vic. 3053, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"Spelman","sequence":"additional","affiliation":[{"name":"AInfectious Diseases Unit, The Alfred Hospital and Department of Medicine, Monash University, Vic. 3004, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyra","family":"Chua","sequence":"additional","affiliation":[{"name":"CInfectious Diseases Unit, Royal Melbourne Hospital, Parkville, Vic. 3050, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher K.","family":"Fairley","sequence":"additional","affiliation":[{"name":"DMelbourne Sexual Health Clinic, Carlton, Vic. 3053, Australia."},{"name":"ESchool of Population Health, University of Melbourne, Vic. 3053, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Street","sequence":"additional","affiliation":[{"name":"CInfectious Diseases Unit, Royal Melbourne Hospital, Parkville, Vic. 3050, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne M.","family":"Crowe","sequence":"additional","affiliation":[{"name":"AInfectious Diseases Unit, The Alfred Hospital and Department of Medicine, Monash University, Vic. 3004, Australia."},{"name":"FBurnet Institute, Melbourne, Vic. 3004, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer F.","family":"Hoy","sequence":"additional","affiliation":[{"name":"AInfectious Diseases Unit, The Alfred Hospital and Department of Medicine, Monash University, Vic. 3004, Australia."},{"name":"GCorresponding author. Email: jennifer.hoy@med.monash.edu.au"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2011,5,18]]},"reference":[{"key":"2025102616583150300_R1","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1097\/QCO.0b013e32801158cc","article-title":"The resurgence of syphilis among men who have sex with men.","volume":"20","author":"Peterman","year":"2007","journal-title":"Curr Opin Infect Dis"},{"key":"2025102616583150300_R2","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1086\/513427","article-title":"Syphilis and HIV infection: an update.","volume":"44","author":"Zetola","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2025102616583150300_R3","unstructured":"McDonald A. HIV\/AIDS, Viral hepatitis and sexually transmissible infections in Australia. Annual surveillance report 2009. Sydney: National Centre in HIV Epidemiology and Clinical Research; 2010. 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Syphilis laboratory case definition. Melbourne: Victorian Infectious Diseases Reference Laboratory; 2008. 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