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There is debate about the circumstances in which to perform a lumbar puncture, and the current gold standard diagnostics have inadequate sensitivity. We recommend a pragmatic approach to lumbar punctures, interpreting investigations and deciding when to consider treatment with a neuropenetrative antibiotic regimen.<\/jats:p>","DOI":"10.1136\/practneurol-2017-001754","type":"journal-article","created":{"date-parts":[[2018,2,24]],"date-time":"2018-02-24T20:20:10Z","timestamp":1519503610000},"page":"211-218","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":72,"title":["Neurosyphilis in patients with HIV"],"prefix":"10.1136","volume":"18","author":[{"given":"Emily","family":"Hobbs","sequence":"first","affiliation":[{"name":"Brighton and Sussex Medical School, University of Sussex, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime H","family":"Vera","sequence":"additional","affiliation":[{"name":"Brighton and Sussex Medical School, University of Sussex, Brighton, UK"},{"name":"Lawson Unit, Royal Sussex County Hospital, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Marks","sequence":"additional","affiliation":[{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9723-6946","authenticated-orcid":false,"given":"Andrew William","family":"Barritt","sequence":"additional","affiliation":[{"name":"Brighton and Sussex Medical School, University of Sussex, Brighton, UK"},{"name":"Hurstwood Park Neurological Centre, Haywards Heath, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basil H","family":"Ridha","sequence":"additional","affiliation":[{"name":"Brighton and Sussex Medical School, University of Sussex, Brighton, UK"},{"name":"Hurstwood Park Neurological Centre, Haywards Heath, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Lawson Unit, Royal Sussex County Hospital, Brighton, UK"},{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,2,24]]},"reference":[{"key":"2025090409274360000_18.3.211.1","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1071\/SH14173","article-title":"Evolution of the syphilis epidemic among men who have sex with men","volume":"12","author":"Solomon","year":"2015","journal-title":"Sex Health"},{"key":"2025090409274360000_18.3.211.2","unstructured":"England PH . 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