{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:44:20Z","timestamp":1792093460853,"version":"4.4.0"},"reference-count":110,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We review key concepts in the diagnosis, treatment, and follow-up of individuals with neurosyphilis. We describe the epidemiology of syphilis in the United States, highlight populations that are markedly affected by this infection, and attempt to estimate the burden of neurosyphilis. We describe the cardinal clinical features of early and late (tertiary) neurosyphilis and characterize the clinical significance of asymptomatic neurosyphilis in the antibiotic era. We review the indications for cerebrospinal fluid (CSF) examination and the performance characteristics of different CSF assays including treponemal and lipoidal antibodies, white cell count, and protein concentration. Future biomarkers and the role of imaging are briefly considered. We review preferred and alternative treatments for neurosyphilis and evidence for their use, including evidence for the use of enhanced intramuscular benzathine penicillin G to supplement intravenous penicillin.<\/jats:p>","DOI":"10.1093\/cid\/ciad437","type":"journal-article","created":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T16:11:19Z","timestamp":1690301479000},"page":"e57-e68","source":"Crossref","is-referenced-by-count":133,"title":["State-of-the-Art Review: Neurosyphilis"],"prefix":"10.1093","volume":"78","author":[{"given":"Matthew M","family":"Hamill","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil G","family":"Ghanem","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Tuddenham","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,18]]},"reference":[{"key":"2024051423585172100_ciad437-B1"},{"issue":"8S","key":"2024051423585172100_ciad437-B2","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1097\/OLQ.0000000000001451","article-title":"Neurosyphilis surveillance: exploring the use of multiple data sources to better understand morbidity in California","volume":"48","author":"Burghardt","year":"2021","journal-title":"Sex Transm Dis"},{"key":"2024051423585172100_ciad437-B3","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1097\/OLQ.0000000000000368","article-title":"Prevalence estimates of complicated syphilis","volume":"42","author":"Dombrowski","year":"2015","journal-title":"Sex Transm Dis"},{"key":"2024051423585172100_ciad437-B4","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1097\/OLQ.0000000000001673","article-title":"Reported neurologic, ocular, and otic manifestations among syphilis cases","volume":"49","author":"Jackson","year":"2022","journal-title":"Sex Transm Dis"},{"key":"2024051423585172100_ciad437-B5","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1056\/NEJMra1901593","article-title":"The modern epidemic of syphilis","volume":"382","author":"Ghanem","year":"2020","journal-title":"N Engl J Med"},{"key":"2024051423585172100_ciad437-B6","first-page":"647","volume-title":"Sexually transmitted diseases","author":"Lukehart","year":"2008"},{"key":"2024051423585172100_ciad437-B7","doi-asserted-by":"crossref","first-page":"855","DOI":"10.7326\/0003-4819-109-11-855","article-title":"Invasion of the central nervous system by Treponema pallidum: implications for diagnosis and treatment","volume":"109","author":"Lukehart","year":"1988","journal-title":"Ann Intern Med"},{"key":"2024051423585172100_ciad437-B8","first-page":"1725","article-title":"Incidence of","volume":"83","author":"Chesney AM","year":"1924","journal-title":"JAMA"},{"key":"2024051423585172100_ciad437-B9","volume-title":"The modern treatment of syphilis","author":"Moore","year":"1943","edition":"2nd ed"},{"key":"2024051423585172100_ciad437-B10","first-page":"45","article-title":"Cooperative clinical studies in the treatment of syphilis: asymptomatic neurosyphilis","volume":"18","author":"O'Leary PA","year":"1937","journal-title":"Vener Dis Inf"},{"key":"2024051423585172100_ciad437-B11","volume-title":"Neurosyphilis","author":"Merritt","year":"1947"},{"key":"2024051423585172100_ciad437-B12","first-page":"99","article-title":"Asymptomatic neurosyphilis: V. 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