Clinical Spectrum and Diagnostic Categorization of Neurosyphilis in Hospitalized Neurology Patients: A 16-Year Retrospective Analysis of Seropositivity
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By
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Duygu Özkan Yaşargün
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August 25, 2026
Clinical Spectrum and Diagnostic Categorization of Neurosyphilis in Hospitalized Neurology Patients
Overview
This study analyzed syphilis seropositivity in hospitalized neurology patients, revealing that 60% of seropositive patients met criteria for confirmed or probable neurosyphilis.
Background
Neurosyphilis presents a diagnostic challenge due to its varied neurological manifestations and the absence of a universally accepted gold standard for diagnosis. The resurgence of syphilis globally necessitates heightened awareness among healthcare professionals, particularly in neurology, where its symptoms can mimic other conditions.
Data Highlights
| Category | Number of Patients |
|---|---|
| Confirmed Neurosyphilis | 10 |
| Probable Neurosyphilis | 5 |
| Non-Neurosyphilis Seropositivity | 10 |
Key Findings
- 25 patients with syphilis seropositivity were analyzed from 9,172 hospitalized neurology patients.
- 10 patients met criteria for confirmed neurosyphilis, 5 for probable neurosyphilis, and 10 for non-neurosyphilis seropositivity.
- No significant differences in age, sex, vascular ischemia, HIV status, or vascular involvement on CT angiography were found among groups.
- Significant differences in MRI findings and positive neurological examination at discharge were observed across diagnostic categories (p = 0.001).
- Significance was particularly noted in comparisons between confirmed neurosyphilis and non-neurosyphilis seropositivity.
Clinical Implications
Clinicians should be aware that seropositivity does not equate to a diagnosis of neurosyphilis and should consider comprehensive assessments including clinical, CSF, and neuroimaging findings.
Conclusion
The findings indicate that while syphilis seropositivity is infrequent among hospitalized neurology patients, a significant proportion meets criteria for neurosyphilis.
Related Resources & Content
- Frontiers in Medicine, 2026 -- Factors associated with cerebrospinal fluid abnormalities suggestive of neurosyphilis in HIV-negative patients with secondary syphilis: a retrospective study
- Infection, 2026 -- Syphilis and neurosyphilis in people living with HIV: analysis of cerebrospinal fluid findings
- Frontiers in Neurology, 2026 -- Neurosyphilis and limbic encephalitis: practical guidance for diagnosis and treatment sequencing at an infection–autoimmunity interface
- Frontiers in Immunology, 2026 -- Diagnostic Value of CSF CXCL8 Combined with Total Protein for Neurosyphilis: A Logistic Regression and ROC Analysis
- CDC, 2014 -- Syphilis (Treponema pallidum) 2014 Case Definition
- CDC, 2024 -- Laboratory Recommendations for Syphilis Testing, United States, 2024
- German guideline on neurosyphilis, 2026 -- Neurological Research and Practice
- Syphilis (Treponema pallidum) 2014 Case Definition | CDC
- CDC Laboratory Recommendations for Syphilis Testing, United States, 2024 | MMWR
- German guideline on neurosyphilis | Neurological Research and Practice | Springer Nature Link
Based on findings from:
From seropositivity to neurosyphilis: clinical spectrum and diagnostic classification in hospitalized neurology patients: a 16-year retrospective study
Duygu Özkan Yaşargün. Frontiers In Neurology, 2026.
https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2026.1911231/full
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