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?When to do a lumbar puncture in patients with syphilis


?When to do a lumbar puncture in patients with syphilis

المعلومة

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Patients who have syphilis and who demonstrate any of the following criteria should have a prompt CSF examination:
- Neurologic or ophthalmic signs or symptoms,
- Evidence of active tertiary syphilis (e.g., aortitis and gumma),
- Treatment failure, or
- HIV infection with late latent syphilis or syphilis of unknown duration.
-If dictated by circumstances and patient preferences, a CSF examination may be performed for patients who do not meet these criteria. Some specialists recommend performing a CSF examination on all patients who have latent syphilis and a nontreponemal serologic test of ≥1:32 or if the patient is HIV-infected with a serum CD4 count ≤350 (104). However, the likelihood of neurosyphilis in this circumstance is unknown. If a CSF examination is performed and the results indicate abnormalities consistent with neurosyphilis, the patient should be treated for neurosyphilis.

المرجع

CDC STD treatment guidelines 2006
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