{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:36:33Z","timestamp":1784543793149,"version":"3.55.0"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T00:00:00Z","timestamp":1665187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005897","name":"Soci\u00e9t\u00e9 Fran\u00e7aise de Dermatologie et de Pathologie Sexuellement Transmissible","doi-asserted-by":"publisher","award":["None"],"award-info":[{"award-number":["None"]}],"id":[{"id":"10.13039\/501100005897","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Many assays are available on cerebrospinal fluid (CSF) for the diagnosis of neurosyphilis (NS) but there is no \u2018gold standard\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to evaluate different molecular and serological assays used in NS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated two PCR assays and three serological techniques in parallel on CSF samples collected between 2019 and 2020 from patients suspected of NS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 143 patients comprising 30 early NS, 7 late NS and 106 patients without a diagnosis of NS. All patients with NS were symptomatic and had either neurological (67.6%) or ophthalmological signs (54.1%). The qPCR and nPCR assays had overall sensitivities (Se) of 41% and 27%, respectively; with each an overall specificity (Sp) of 100%. VDRL had a Se of 51% and a Sp of 92%. Immunoblot had a Se of 62% and a Sp of 85%. Finally, treponemal tests (TT) had a Se of 96% and a Sp of 69%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study confirms the excellent specificity of molecular techniques allowing to avoid overdiagnosis of NS, and thus, unjustified intensive antibiotic therapy protocols. CSF TT, although not very specific, has an excellent Se confirming that there is almost never NS with negative CSF TT. VDRL and immunoblot tests have better overall diagnostic performance. However, none of these techniques has sufficient diagnostic performance to represent a \u2018gold standard\u2019. Thus, the diagnosis of NS relies on a combination of clinical and biological parameters with the association of PCR with serology, associating VDRL and immunoblot, in CSF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.18604","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T12:52:21Z","timestamp":1664283141000},"page":"390-394","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Comparison of molecular and serological assays on cerebrospinal fluid for the diagnosis of neurosyphilis"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4411-7289","authenticated-orcid":false,"given":"Romain","family":"Salle","sequence":"first","affiliation":[{"name":"INSERM, Institut Cochin U1016\u2010CNRS UMR8104, \u00c9quipe Biologie Cutan\u00e9 Universit\u00e9 de Paris Cit\u00e9  Paris France"},{"name":"Service de Dermatologie\u2010V\u00e9n\u00e9r\u00e9ologie et CeGIDD H\u00f4pital Cochin, APHP, CNR IST Bact\u00e9riennes \u2013 Expertise Syphilis  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8151-748X","authenticated-orcid":false,"given":"Philippe A.","family":"Grange","sequence":"additional","affiliation":[{"name":"INSERM, Institut Cochin U1016\u2010CNRS UMR8104, \u00c9quipe Biologie Cutan\u00e9 Universit\u00e9 de Paris Cit\u00e9  Paris France"},{"name":"Service de Dermatologie\u2010V\u00e9n\u00e9r\u00e9ologie et CeGIDD H\u00f4pital Cochin, APHP, CNR IST Bact\u00e9riennes \u2013 Expertise Syphilis  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Ollagnier","sequence":"additional","affiliation":[{"name":"INSERM, Institut Cochin U1016\u2010CNRS UMR8104, \u00c9quipe Biologie Cutan\u00e9 Universit\u00e9 de Paris Cit\u00e9  Paris France"},{"name":"Service de Dermatologie\u2010V\u00e9n\u00e9r\u00e9ologie et CeGIDD H\u00f4pital Cochin, APHP, CNR IST Bact\u00e9riennes \u2013 Expertise Syphilis  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadjet","family":"Benhaddou","sequence":"additional","affiliation":[{"name":"INSERM, Institut Cochin U1016\u2010CNRS UMR8104, \u00c9quipe Biologie Cutan\u00e9 Universit\u00e9 de Paris Cit\u00e9  Paris France"},{"name":"Service de Bact\u00e9riologie, APHP CNR IST Bact\u00e9riennes \u2013 Expertise Syphilis  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugo","family":"Heller","sequence":"additional","affiliation":[{"name":"Service de Chirurgie Maxillo\u2010Faciale H\u00f4pital Beaujon, APHP  Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6237-4951","authenticated-orcid":false,"given":"Nicolas","family":"Dupin","sequence":"additional","affiliation":[{"name":"INSERM, Institut Cochin U1016\u2010CNRS UMR8104, \u00c9quipe Biologie Cutan\u00e9 Universit\u00e9 de Paris Cit\u00e9  Paris France"},{"name":"Service de Dermatologie\u2010V\u00e9n\u00e9r\u00e9ologie et CeGIDD H\u00f4pital Cochin, APHP, CNR IST Bact\u00e9riennes \u2013 Expertise Syphilis  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0159309"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1906228"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e31824b1cde"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0732-8893(00)00213-3"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e31824c0e62"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2018-053666"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-021-06264-8"},{"key":"e_1_2_8_9_1","unstructured":"Syphilis (Treponema pallidum) 2018 Case Definition | CDC. 2021. 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Available from:https:\/\/ndc.services.cdc.gov\/case\u2010definitions\/syphilis\u20102018\/"},{"key":"e_1_2_8_10_1","first-page":"1180","article-title":"Clinical and biological characteristics of 40 patients with neurosyphilis and evaluation of treponema pallidum nested polymerase chain reaction in cerebrospinal fluid samples","volume":"63","author":"Vanhaecke C","year":"2016","journal-title":"Clin Infect Dis"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00702-11"},{"key":"e_1_2_8_12_1","article-title":"Specific detection of treponema pallidum in clinical samples: validation of a qPCR assay combining two genomic targets","volume":"2021","author":"Salle R","year":"2022","journal-title":"Sex Transm Infect"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000723"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.18604","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jdv.18604","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.18604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T13:45:08Z","timestamp":1692711908000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.18604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,8]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1111\/jdv.18604"],"URL":"https:\/\/doi.org\/10.1111\/jdv.18604","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,8]]},"assertion":[{"value":"2022-07-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}