{"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":1792093460859,"version":"4.4.0"},"reference-count":58,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol. Res. Pract."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Neurosyphilis is a severe disease which can manifest with various clinical signs. The diagnosis can be challenging. Patients with positive syphilis serology and neurological or psychiatric symptoms should undergo cerebrospinal fluid (CSF) examination. The definite diagnosis is based on CSF findings, including evidence of inflammation, intrathecal production of treponemal antibodies (plus reactive non-treponema specific tests in the CSF). However, these criteria are not always fulfilled and a diagnosis of probable neurosyphilis may be established using less stringent diagnostic criteria. Treatment with intravenous penicillin or ceftriaxone is recommended for neurosyphilis. Here, a short version of the recommendations of the German guidelines on neurosyphilis that were published in 2026 is presented.<\/jats:p>","DOI":"10.1186\/s42466-026-00525-0","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:08:12Z","timestamp":1787321292000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["German guideline on neurosyphilis"],"prefix":"10.1186","volume":"8","author":[{"given":"Matthias","family":"Klein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klemens","family":"Angstwurm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Esser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"Fazio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Hahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Scheithauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Potthoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Chilver-Stainer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Weber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Niklas","family":"Werner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Wildmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Maschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"issue":"11","key":"525_CR1","doi-asserted-by":"publisher","first-page":"1510","DOI":"10.1001\/jama.290.11.1510","volume":"290","author":"MR Golden","year":"2003","unstructured":"Golden, M. R., Marra, C. M., & Holmes, K. K. (2003). Update on syphilis: resurgence of an old problem. Journal Of The American Medical Association, 290(11), 1510\u20131514.","journal-title":"Journal Of The American Medical Association"},{"issue":"12","key":"525_CR2","doi-asserted-by":"publisher","first-page":"1581","DOI":"10.1111\/jdv.12734","volume":"28","author":"M Janier","year":"2014","unstructured":"Janier, M., Hegyi, V., Dupin, N., Unemo, M., Tiplica, G. S., Potocnik, M., et al. (2014). 2014 European guideline on the management of syphilis. Journal Of The European Academy Of Dermatology And Venereology, 28(12), 1581\u20131593.","journal-title":"Journal Of The European Academy Of Dermatology And Venereology"},{"key":"525_CR3","doi-asserted-by":"publisher","first-page":"17073","DOI":"10.1038\/nrdp.2017.73","volume":"3","author":"RW Peeling","year":"2017","unstructured":"Peeling, R. W., Mabey, D., Kamb, M. L., Chen, X. S., Radolf, J. D., Benzaken, A. S., & Syphilis (2017). Nat Rev Dis Primers. ;3:17073.","journal-title":"Nat Rev Dis Primers"},{"key":"525_CR4","unstructured":"Potthoff, A. (2026). Diagnostik und Therapie der Syphilis. Deutsche STI-Gesellschaft (DSTIG). ;AWMF-Leitlinie 059\/002."},{"key":"525_CR5","unstructured":"Klein, M., Maschke, M., Angstwurm, K., Esser, S., Fazio, J., Hahn, K. Neurosyphilis, S1-Leitlinie. Leitlinien f\u00fcr Diagnostik und Therapie in der Neurologie 2026;AWMF-Registernummer: 030\/101."},{"issue":"12","key":"525_CR6","doi-asserted-by":"publisher","first-page":"e0143304","DOI":"10.1371\/journal.pone.0143304","volume":"10","author":"L Newman","year":"2015","unstructured":"Newman, L., Rowley, J., Vander Hoorn, S., Wijesooriya, N. S., Unemo, M., Low, N., et al. (2015). Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting. PLoS One, 10(12), e0143304.","journal-title":"PLoS One"},{"key":"525_CR7","unstructured":"WHO (2021). Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Accountability for the global health sector strategies 2016\u20132021: actions for impact."},{"key":"525_CR8","unstructured":"Syphilis in Deutschland (2012). Epidemiologisches Bulletin. 2014;44:449\u2009\u2013\u200954."},{"key":"525_CR9","unstructured":"RKI. Epidemiologisches Bulletin. (2025). 39."},{"issue":"3","key":"525_CR10","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1097\/QAI.0b013e31802ea4c6","volume":"44","author":"R Palacios","year":"2007","unstructured":"Palacios, R., Jimenez-Onate, F., Aguilar, M., Galindo, M. J., Rivas, P., Ocampo, A., et al. (2007). Impact of syphilis infection on HIV viral load and CD4 cell counts in HIV-infected patients. Journal Of Acquired Immune Deficiency Syndromes, 44(3), 356\u2013359.","journal-title":"Journal Of Acquired Immune Deficiency Syndromes"},{"issue":"1","key":"525_CR11","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1097\/OLQ.0000000000000687","volume":"45","author":"A de Voux","year":"2018","unstructured":"de Voux, A., Kidd, S., & Torrone, E. A. (2018). Reported Cases of Neurosyphilis Among Early Syphilis Cases-United States, 2009 to 2015. Sx Transm Dis, 45(1), 39\u201341.","journal-title":"Sx Transm Dis"},{"issue":"5","key":"525_CR12","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1097\/OLQ.0b013e3181644b5e","volume":"35","author":"MM Taylor","year":"2008","unstructured":"Taylor, M. M., Aynalem, G., Olea, L. M., He, P., Smith, L. V., & Kerndt, P. R. (2008). A consequence of the syphilis epidemic among men who have sex with men (MSM): neurosyphilis in Los Angeles, 2001\u20132004. Sexually Transmitted Diseases, 35(5), 430\u2013434.","journal-title":"Sexually Transmitted Diseases"},{"issue":"5","key":"525_CR13","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1111\/hiv.12307","volume":"17","author":"E Firlag-Burkacka","year":"2016","unstructured":"Firlag-Burkacka, E., Swiecki, P., Cielniak, I., Siwak, E., Gizinska, J., Bakowska, E., et al. (2016). High frequency of neurosyphilis in HIV-positive patients diagnosed with early syphilis. Hiv Medicine, 17(5), 323\u2013326.","journal-title":"Hiv Medicine"},{"key":"525_CR14","unstructured":"RKI. Epidemiologisches Bulletin. (2019);50."},{"issue":"3","key":"525_CR15","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1097\/00007435-200103000-00007","volume":"28","author":"AM Rompalo","year":"2001","unstructured":"Rompalo, A. M., Joesoef, M. R., O\u2019Donnell, J. A., Augenbraun, M., Brady, W., Radolf, J. D., et al. (2001). Clinical manifestations of early syphilis by HIV status and gender: results of the syphilis and HIV study. Sexually Transmitted Diseases, 28(3), 158\u2013165.","journal-title":"Sexually Transmitted Diseases"},{"issue":"6","key":"525_CR16","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1097\/MD.0b013e3181c2af86","volume":"88","author":"D Farhi","year":"2009","unstructured":"Farhi, D., Benhaddou, N., Grange, P., Zizi, N., Deleuze, J., Morini, J. P., et al. (2009). Clinical and serologic baseline and follow-up features of syphilis according to HIV status in the post-HAART era. Medicine (Baltimore), 88(6), 331\u2013340.","journal-title":"Medicine (Baltimore)"},{"key":"525_CR17","doi-asserted-by":"crossref","unstructured":"Lukehart, S. A., Hook, E. W. 3rd, Baker-Zander, S. A., Collier, A. C., Critchlow, C. W., & Handsfield, H. H. (1988). Invasion of the central nervous system by Treponema pallidum: implications for diagnosis and treatment. Annals Of Internal Medicine, 109(11), 855\u2013862.","DOI":"10.7326\/0003-4819-109-11-855"},{"key":"525_CR18","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1001\/archinte.1964.03860120104011","volume":"114","author":"DH Rockwell","year":"1964","unstructured":"Rockwell, D. H., Yobs, A. R., & Moore, M. B. (1964). Jr. The Tuskegee Study of Untreated Syphilis; the 30th Year of Observation. Archives Of Internal Medicine, 114, 792\u2013798.","journal-title":"Archives Of Internal Medicine"},{"issue":"10","key":"525_CR19","doi-asserted-by":"publisher","first-page":"1505","DOI":"10.1001\/archneur.61.10.1505","volume":"61","author":"CM Marra","year":"2004","unstructured":"Marra, C. M. (2004). Syphilis and human immunodeficiency virus: prevention and politics. Archives Of Neurology, 61(10), 1505\u20131508.","journal-title":"Archives Of Neurology"},{"issue":"9554","key":"525_CR20","doi-asserted-by":"publisher","first-page":"2258","DOI":"10.1016\/S0140-6736(06)69900-5","volume":"368","author":"VV Brinar","year":"2006","unstructured":"Brinar, V. V., & Habek, M. (2006). Dementia and white-matter demyelination in young patient with neurosyphilis. Lancet, 368(9554), 2258.","journal-title":"Lancet"},{"issue":"7","key":"525_CR21","first-page":"797","volume":"59","author":"K Obi","year":"2007","unstructured":"Obi, K., Tsuchiya, K., Anno, M., Ohta, S., Nakamura, R., & Akiyama, H. (2007). [Autopsy case of meningovascular neurosyphilis associated with Fischer\u2019s plaques]. Brain And Nerve, 59(7), 797\u2013803.","journal-title":"Brain And Nerve"},{"issue":"12","key":"525_CR22","first-page":"4222","volume":"148","author":"CM Marra","year":"2025","unstructured":"Marra, C. M. (2025). Neurosyphilis Brain. ;148(12):4222\u20134240.","journal-title":"Neurosyphilis Brain"},{"issue":"5","key":"525_CR23","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/j.neurol.2017.07.014","volume":"174","author":"N Ahbeddou","year":"2018","unstructured":"Ahbeddou, N., El Alaoui Taoussi, K., Ibrahimi, A., Ait Ben Haddou, E. H., Regragui, W., Benomar, A., et al. (2018). Stroke and syphilis: A retrospective study of 53 patients. Rev Neurol (Paris), 174(5), 313\u2013318.","journal-title":"Rev Neurol (Paris)"},{"issue":"4","key":"525_CR24","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1007\/s00330-003-2015-4","volume":"14","author":"J Gaa","year":"2004","unstructured":"Gaa, J., Weidauer, S., Sitzer, M., Lanfermann, H., & Zanella, F. E. (2004). Cerebral vasculitis due to Treponema pallidum infection: MRI and MRA findings. European Radiology, 14(4), 746\u2013747.","journal-title":"European Radiology"},{"issue":"7","key":"525_CR25","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1111\/ijd.12095","volume":"53","author":"Z Khamaysi","year":"2014","unstructured":"Khamaysi, Z., Bergman, R., Telman, G., & Goldsher, D. (2014). Clinical and imaging findings in patients with neurosyphilis: a study of a cohort and review of the literature. International Journal Of Dermatology, 53(7), 812\u2013819.","journal-title":"International Journal Of Dermatology"},{"issue":"4","key":"525_CR26","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1007\/s00234-012-1017-9","volume":"55","author":"M Nagappa","year":"2013","unstructured":"Nagappa, M., Sinha, S., Taly, A. B., Rao, S. L., Nagarathna, S., Bindu, P. S., et al. (2013). Neurosyphilis: MRI features and their phenotypic correlation in a cohort of 35 patients from a tertiary care university hospital. Neuroradiology, 55(4), 379\u2013388.","journal-title":"Neuroradiology"},{"issue":"3","key":"525_CR27","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1227\/01.NEU.0000337079.12137.89","volume":"64","author":"KM Fargen","year":"2009","unstructured":"Fargen, K. M., Alvernia, J. E., Lin, C. S., & Melgar, M. (2009). Cerebral syphilitic gummata: a case presentation and analysis of 156 reported cases. Neurosurgery, 64(3), 568\u2013575. discussioin 75 \u2013 6.","journal-title":"Neurosurgery"},{"issue":"3","key":"525_CR28","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1176\/jnp.23.3.jnp300","volume":"23","author":"D Zheng","year":"2011","unstructured":"Zheng, D., Zhou, D., Zhao, Z., Liu, Z., Xiao, S., Xing, Y., et al. (2011). The clinical presentation and imaging manifestation of psychosis and dementia in general paresis: a retrospective study of 116 cases. Journal Of Neuropsychiatry And Clinical Neurosciences, 23(3), 300\u2013307.","journal-title":"Journal Of Neuropsychiatry And Clinical Neurosciences"},{"issue":"3","key":"525_CR29","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1136\/sextrans-2012-050622","volume":"89","author":"A Gayet-Ageron","year":"2013","unstructured":"Gayet-Ageron, A., Lautenschlager, S., Ninet, B., Perneger, T. V., & Combescure, C. (2013). Sensitivity, specificity and likelihood ratios of PCR in the diagnosis of syphilis: a systematic review and meta-analysis. Sexually Transmitted Infections, 89(3), 251\u2013256.","journal-title":"Sexually Transmitted Infections"},{"issue":"9","key":"525_CR30","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1093\/cid\/ciw499","volume":"63","author":"C Vanhaecke","year":"2016","unstructured":"Vanhaecke, C., Grange, P., Benhaddou, N., Blanche, P., Salmon, D., Parize, P., et al. (2016). Clinical and Biological Characteristics of 40 Patients With Neurosyphilis and Evaluation of Treponema pallidum Nested Polymerase Chain Reaction in Cerebrospinal Fluid Samples. Clinical Infectious Diseases, 63(9), 1180\u20131186.","journal-title":"Clinical Infectious Diseases"},{"key":"525_CR31","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1186\/s12879-015-1209-0","volume":"15","author":"AC Sena","year":"2015","unstructured":"Sena, A. C., Zhang, X. H., Li, T., Zheng, H. P., Yang, B., Yang, L. G., et al. (2015). A systematic review of syphilis serological treatment outcomes in HIV-infected and HIV-uninfected persons: rethinking the significance of serological non-responsiveness and the serofast state after therapy. Bmc Infectious Diseases, 15, 479.","journal-title":"Bmc Infectious Diseases"},{"issue":"14","key":"525_CR32","doi-asserted-by":"publisher","first-page":"1358","DOI":"10.1056\/NEJMra1906228","volume":"381","author":"AH Ropper","year":"2019","unstructured":"Ropper, A. H., & Neurosyphilis (2019). New England Journal Of Medicine. ;381(14):1358\u20131363.","journal-title":"New England Journal Of Medicine"},{"issue":"1","key":"525_CR33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.rr7301a1","volume":"73","author":"JR Papp","year":"2024","unstructured":"Papp, J. R., Park, I. U., Fakile, Y., Pereira, L., Pillay, A., & Bolan, G. A. (2024). CDC Laboratory Recommendations for Syphilis Testing, United States, 2024. Mmwr. Recommendations And Reports : Morbidity And Mortality Weekly Report. Recommendations And Reports \/ Centers For Disease Control, 73(1), 1\u201332.","journal-title":"Mmwr. Recommendations And Reports : Morbidity And Mortality Weekly Report. Recommendations And Reports \/ Centers For Disease Control"},{"issue":"RR-12","key":"525_CR34","first-page":"1","volume":"59","author":"KA Workowski","year":"2010","unstructured":"Workowski, K. A., Berman, S., & Centers for Disease, C. (2010). Prevention. Sexually transmitted diseases treatment guidelines, 2010. Mmwr. Recommendations And Reports : Morbidity And Mortality Weekly Report. Recommendations And Reports \/ Centers For Disease Control, 59(RR-12), 1\u2013110.","journal-title":"Mmwr. Recommendations And Reports : Morbidity And Mortality Weekly Report. Recommendations And Reports \/ Centers For Disease Control"},{"issue":"6","key":"525_CR35","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1159\/000531341","volume":"86","author":"D Ding","year":"2023","unstructured":"Ding, D., Gao, J., Zhang, W., & Xu, D. (2023). The Diagnostic Performance of Laboratory Tests of Neurosyphilis: A Systematic Review and Network Meta-Analysis. European Neurology, 86(6), 418\u2013429.","journal-title":"European Neurology"},{"issue":"2","key":"525_CR36","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1128\/CMR.12.2.187","volume":"12","author":"AE Singh","year":"1999","unstructured":"Singh, A. E., & Romanowski, B. (1999). Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. Clinical Microbiology Reviews, 12(2), 187\u2013209.","journal-title":"Clinical Microbiology Reviews"},{"issue":"4","key":"525_CR37","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1309\/AJCPWSL3G8RXMCQR","volume":"143","author":"J Guarner","year":"2015","unstructured":"Guarner, J., Jost, H., Pillay, A., Sun, Y., Cox, D., Notenboom, R., et al. (2015). Evaluation of treponemal serum tests performed on cerebrospinal fluid for diagnosis of neurosyphilis. American Journal Of Clinical Pathology, 143(4), 479\u2013484.","journal-title":"American Journal Of Clinical Pathology"},{"key":"525_CR38","unstructured":"Hagedorn, H. J., Brockmeyer, N., Hunfeld, K., M\u00fcnstermann, D., Potthoff, A., & Sch\u00f6fer, H. (2012). MiQ 16: Qualit\u00e4tsstandards in der mikrobiologisch-infektiologischen Diagnostik: Syphilis. Urban & Fischer (Verlag)."},{"key":"525_CR39","doi-asserted-by":"crossref","unstructured":"Tumani, H., & Petereit, H-F. (2019). S1-Leitlinie Lumbalpunktion und Liquordiagnostik. AWMF Leitlinien.","DOI":"10.1007\/s42451-019-00126-z"},{"issue":"8","key":"525_CR40","doi-asserted-by":"publisher","first-page":"2927","DOI":"10.3390\/ijms21082927","volume":"21","author":"M Gudowska-Sawczuk","year":"2020","unstructured":"Gudowska-Sawczuk, M., & Mroczko, B. (2020). Chemokine Ligand 13 (CXCL13) in Neuroborreliosis and Neurosyphilis as Selected Spirochetal Neurological Diseases: A Review of Its Diagnostic Significance. International Journal Of Molecular Sciences, 21(8), 2927.","journal-title":"International Journal Of Molecular Sciences"},{"key":"525_CR41","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s12987-015-0008-8","volume":"12","author":"R Dersch","year":"2015","unstructured":"Dersch, R., Hottenrott, T., Senel, M., Lehmensiek, V., Tumani, H., Rauer, S., et al. (2015). The chemokine CXCL13 is elevated in the cerebrospinal fluid of patients with neurosyphilis. Fluids Barriers CNS, 12, 12.","journal-title":"Fluids Barriers CNS"},{"issue":"12","key":"525_CR42","doi-asserted-by":"publisher","first-page":"1234","DOI":"10.1016\/j.cmi.2018.04.007","volume":"24","author":"TA Rupprecht","year":"2018","unstructured":"Rupprecht, T. A., Manz, K. M., Fingerle, V., Lechner, C., Klein, M., Pfirrmann, M., et al. (2018). Diagnostic value of cerebrospinal fluid CXCL13 for acute Lyme neuroborreliosis. A systematic review and meta-analysis. Clinical Microbiology & Infection, 24(12), 1234\u20131240.","journal-title":"Clinical Microbiology & Infection"},{"issue":"5","key":"525_CR43","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1097\/QAD.0000000000003813","volume":"38","author":"RS Carvalho","year":"2024","unstructured":"Carvalho, R. S., Rangel, I. C., Soane, M. M., Bacarov, N. B. S., Herbst, V., & Ferry, F. R. A. (2024). Cerebrospinal fluid CXCL13 concentration for diagnosis and monitoring of neurosyphilis in people with HIV. Aids, 38(5), 657\u2013668.","journal-title":"Aids"},{"issue":"5","key":"525_CR44","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1097\/OLQ.0b013e3181d877a1","volume":"37","author":"CM Marra","year":"2010","unstructured":"Marra, C. M., Tantalo, L. C., Sahi, S. K., Maxwell, C. L., & Lukehart, S. A. (2010). CXCL13 as a cerebrospinal fluid marker for neurosyphilis in HIV-infected patients with syphilis. Sexually Transmitted Diseases, 37(5), 283\u2013287.","journal-title":"Sexually Transmitted Diseases"},{"key":"525_CR45","doi-asserted-by":"crossref","unstructured":"Sch\u00f6fer, H. B., Esser, N., Feiterna-Sperling, S., Hahn, C. N., Jansen, K., Klein, K., Magistro, M., Maschke, G., Mayr, M., Ochsendorf, C., Petry, F. R., Rieg, H. U., Sing, S., & Werner, A. (2020). R.;. Diagnostik und Therapie der Syphilis. Deutsche STI-Gesellschaft (DSTIG). ;AWMF-Leitlinie 059\/002.","DOI":"10.1007\/s00105-020-04672-6"},{"key":"525_CR46","first-page":"2426313","volume":"2019","author":"W Li","year":"2019","unstructured":"Li, W., Jiang, M., Xu, D., Kou, C., Zhang, L., Gao, J., et al. (2019). Clinical and Laboratory Characteristics of Symptomatic and Asymptomatic Neurosyphilis in HIV-Negative Patients: A Retrospective Study of 264 Cases. Biomed Research International, 2019, 2426313.","journal-title":"Biomed Research International"},{"issue":"9","key":"525_CR47","doi-asserted-by":"publisher","first-page":"e0078","DOI":"10.1097\/MD.0000000000010078","volume":"97","author":"Z Wang","year":"2018","unstructured":"Wang, Z., Liu, L., Shen, Y. Z., Zhang, R. F., Qi, T. K., Tang, Y., et al. (2018). The clinical and laboratory features of neurosyphilis in HIV-infected patients: A retrospective study in 92 patients. Medicine (Baltimore), 97(9), e0078.","journal-title":"Medicine (Baltimore)"},{"issue":"45","key":"525_CR48","doi-asserted-by":"publisher","first-page":"e13171","DOI":"10.1097\/MD.0000000000013171","volume":"97","author":"M Pastuszczak","year":"2018","unstructured":"Pastuszczak, M., Sitko, M., Bociaga-Jasik, M., Kucharz, J., & Wojas-Pelc, A. (2018). Lack of antiretroviral therapy is associated with higher risk of neurosyphilis among HIV-infected patients who remain serofast after therapy for early syphilis. Medicine (Baltimore), 97(45), e13171.","journal-title":"Medicine (Baltimore)"},{"issue":"10513","key":"525_CR49","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1016\/S0140-6736(25)01917-8","volume":"406","author":"Global burden","year":"2025","unstructured":"Global burden. (2025). of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990\u20132023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet, 406(10513), 1811\u20131872.","journal-title":"Lancet"},{"key":"525_CR50","unstructured":"WHO (2016). WHO Guidelines for the Treatment of Treponema pallidum (syphilis)."},{"issue":"15","key":"525_CR51","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1212\/WNL.0000000000002023","volume":"85","author":"R Sutter","year":"2015","unstructured":"Sutter, R., Ruegg, S., & Tschudin-Sutter, S. (2015). Seizures as adverse events of antibiotic drugs: A systematic review. Neurology, 85(15), 1332\u20131341.","journal-title":"Neurology"},{"key":"525_CR52","unstructured":"Neurosyphilis, C. D. C. (2021). Ocular syphilis, and Otosyphilis."},{"issue":"1","key":"525_CR53","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s42466-026-00497-1","volume":"8","author":"S Dyckhoff-Shen","year":"2026","unstructured":"Dyckhoff-Shen, S., Masouris, I., V\u00f6lk, S., Pusl, K., Seybold, U., & Klein, M. (2026). Clinical presentation of neurosyphilis - a single-center retrospective data analysis. Neurol Res Pract, 8(1), 35.","journal-title":"Neurol Res Pract"},{"issue":"10","key":"525_CR54","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1097\/OLQ.0000000000001983","volume":"51","author":"GY Callado","year":"2024","unstructured":"Callado, G. Y., Pardo, I., Gutfreund, M. C., Deliberato, R. O., Holubar, M., Salinas, J. L., et al. (2024). Insights Into Treatment Alternatives for Neurosyphilis: Systematic Literature Review and Meta-Analysis. Sexually Transmitted Diseases, 51(10), 641\u2013647.","journal-title":"Sexually Transmitted Diseases"},{"issue":"8","key":"525_CR55","first-page":"e67775","volume":"16","author":"S Mehta","year":"2024","unstructured":"Mehta, S., Medhekar, A., & Sarma, S. (2024). Isolated Intraocular Jarisch-Herxheimer Reaction Following Treatment for Syphilitic Chorioretinitis. Cureus, 16(8), e67775.","journal-title":"Cureus"},{"issue":"5","key":"525_CR56","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1016\/j.jiac.2018.11.007","volume":"25","author":"H Komamura","year":"2019","unstructured":"Komamura, H., Nakamura, T., Kobayashi, J., Harada, R., Endo, K., Ogura, M., et al. (2019). Early neurosyphilis presenting with multiple cranial nerve palsies: A case report of management by combined penicillin-corticosteroid treatment. Journal Of Infection And Chemotherapy : Official Journal Of The Japan Society Of Chemotherapy, 25(5), 362\u2013364.","journal-title":"Journal Of Infection And Chemotherapy : Official Journal Of The Japan Society Of Chemotherapy"},{"issue":"1","key":"525_CR57","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1097\/OLQ.0000000000000899","volume":"46","author":"TA Peterman","year":"2019","unstructured":"Peterman, T. A., & Kidd, S. E. (2019). Trends in Deaths Due to Syphilis, United States, 1968\u20132015. Sexually Transmitted Diseases, 46(1), 37\u201340.","journal-title":"Sexually Transmitted Diseases"},{"issue":"1","key":"525_CR58","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s10096-018-3403-7","volume":"38","author":"D Ozturk-Engin","year":"2019","unstructured":"Ozturk-Engin, D., Erdem, H., Hasbun, R., Wang, S. H., Tireli, H., Tattevin, P., et al. (2019). Predictors of unfavorable outcome in neurosyphilis: Multicenter ID-IRI Study. European Journal Of Clinical Microbiology And Infectious Diseases, 38(1), 125\u2013134.","journal-title":"European Journal Of Clinical Microbiology And Infectious Diseases"}],"container-title":["Neurological Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42466-026-00525-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42466-026-00525-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42466-026-00525-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T16:03:24Z","timestamp":1787328204000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s42466-026-00525-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":58,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["525"],"URL":"https:\/\/doi.org\/10.1186\/s42466-026-00525-0","relation":{},"ISSN":["2524-3489"],"issn-type":[{"value":"2524-3489","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"assertion":[{"value":"20 July 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Consent for publication was given by all authors and the German Neurological Society.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"JF has received speaker fees from Abbott and Euroimmun. MK, KA, SE, KH, SS, AP, LCS, JW, RNW, BW, and MM declare no conflicts of interest. Please see Table with COIs for details: www.dgn.org\/leitlinie\/neurosyphilis.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"68"}}