Abstract：
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.
摘要：
我们回顾了诊断中的关键概念，治疗,以及神经梅毒患者的随访。我们描述了美国梅毒的流行病学，突出受这种感染显著影响的人群，并试图估计神经梅毒的负担。我们描述了早期和晚期（三级）神经梅毒的主要临床特征，并描述了抗生素时代无症状神经梅毒的临床意义。我们回顾了脑脊液（CSF）检查的适应症以及包括螺旋体和类脂抗体在内的不同CSF测定的性能特征，白细胞计数,和蛋白质浓度。简要考虑了未来的生物标志物和成像的作用。我们回顾了神经梅毒的首选和替代疗法及其使用证据，包括使用增强肌内注射苄星青霉素G补充静脉注射青霉素的证据。
