{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:45Z","timestamp":1787017005819,"version":"build-2736575974"},"reference-count":12,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2012,2,5]]},"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To study 17 cases of secondary syphilis that progressed to neurosyphilis despite appropriate treatments and whose rapid plasma reagin (RPR) titres showed a fourfold decrease within 6\u2005months but did not revert to negative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Secondary syphilis patients with the following criteria were analysed: (1) RPR titres declined fourfold within 3\u2005months after therapy, (2) patients denied high-risk sexual behaviours following treatment, (3) RPR titre remained serofast 24\u2005months after treatment, (4) reactive cerebrospinal fluid (CSF)\u2013venereal disease research laboratory (VDRL) and CSF\u2013\n                      <jats:italic>Treponema pallidum<\/jats:italic>\n                      Particle Agglutination Test (TPPA) and (5) HIV antibody negative.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>14 male and three female patients met the criteria. 13 patients were asymptomatic. The CSF leucocyte count was elevated in 10 patients of whom nine also had elevated CSF\u2013proteins. The RPR titres following secondary syphilis treatments were \u22651:32 in five cases, 1:16 in four cases, 1:8 in six cases and 1:4 in two cases. Following treatments for neurosyphilis, four cases with neurological or psychiatric manifestations resolved or improved, nine cases with raised CSF\u2013white blood cells returned to normal and nine of 12 cases with raised CSF\u2013protein declined to normal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neurosyphilis may be detected in immunocompetent patients despite appropriate therapy for early-stage syphilis and appropriate serological responses. Clinicians should consider a CSF examination in any treated patient with evidence of disease progression irrespective of prior treatment history and serological response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2011-050247","type":"journal-article","created":{"date-parts":[[2012,2,23]],"date-time":"2012-02-23T21:02:24Z","timestamp":1330030944000},"page":"342-345","source":"Crossref","is-referenced-by-count":49,"title":["Re-evaluation of serological criteria for early syphilis treatment efficacy: progression to neurosyphilis despite therapy"],"prefix":"10.1136","volume":"88","author":[{"given":"Pingyu","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haikong","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhifang","family":"Guan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihong","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2012,2,23]]},"reference":[{"key":"2024051320534531000_88.5.342.1","first-page":"26","article-title":"Sexually transmitted diseases treatment guidelines, 2010","volume":"59","author":"Workowski","year":"2010","journal-title":"MMWR Recomm Rep"},{"key":"2024051320534531000_88.5.342.2","unstructured":"Chinese Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines [Chinese]. Shanghai: Shanghai Scientific & Technical Publishers, 2007:1\u201316."},{"key":"2024051320534531000_88.5.342.3","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1016\/S0140-6736(68)92674-3","article-title":"Prognosis of general paresis after treatment","volume":"2","author":"Wilner","year":"1968","journal-title":"Lancet"},{"key":"2024051320534531000_88.5.342.4","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1982.00340140141023"},{"key":"2024051320534531000_88.5.342.5","first-page":"1","article-title":"2009' report on syphilis and Gonorrhea epidemic analysis in China","volume":"242","author":"Chinese Center for Disease Prevention and Control","year":"2010","journal-title":"Bull STI Prev Control"},{"key":"2024051320534531000_88.5.342.6","unstructured":"Ministry of Health of China. 2010 Report of Incidence and Morbidity of National Infectious Diseases [Chinese]. 2011. http:\/\/61.49.18.65\/publicfiles\/\/\/business\/cmsresources\/mohjbyfkzj\/cmsrsdocument\/doc11195.doc"},{"key":"2024051320534531000_88.5.342.7","first-page":"293","article-title":"Survival of treponemes after treatment, comments, clinical conclusions and recommendations","volume":"61","author":"Dunlop","year":"1985","journal-title":"Genitourin Med"},{"key":"2024051320534531000_88.5.342.8","doi-asserted-by":"publisher","DOI":"10.1086\/500406"},{"key":"2024051320534531000_88.5.342.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199707313370504"},{"key":"2024051320534531000_88.5.342.10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1981.03320220033020"},{"key":"2024051320534531000_88.5.342.11","doi-asserted-by":"crossref","first-page":"855","DOI":"10.7326\/0003-4819-109-11-855","article-title":"Invasion of the central system by Treponema pallidum: implications for diagnosis and treatment","volume":"109","author":"Lukehart","year":"1988","journal-title":"Ann Intern Med"},{"key":"2024051320534531000_88.5.342.12","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1056\/NEJM198706183162507","article-title":"Neurological relapse following benzathine penicillin therapy for secondary syphilis in a patient with HIV infection","volume":"316","author":"Berry","year":"1987","journal-title":"N Engl J Med"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2011-050247","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:16:38Z","timestamp":1715645798000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2011-050247"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,2,23]]},"references-count":12,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2012,7,13]]},"published-print":{"date-parts":[[2012,8]]}},"alternative-id":["10.1136\/sextrans-2011-050247"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2011-050247","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2,23]]}}}