Ghanem et al listed criteria the diagnosis of asymptomatic neurosyphilis in an HIV-infected patient with syphilis. Early diagnosis and therapy are important to prevent late sequelae. The authors are from the Johns Hopkins University in Baltimore.
Asymptomatic neurosyphilis should be suspected in an HIV-infected patient with syphilis and all of the following:
(1) an absence of neurologic signs and symptoms (asymptomatic)
(2) reactive syphilis serologic test results on serum
(3) one or more of the following abnormalities in the CSF:
(3a) CSF WBC count > 10 cells per µL without an alternative explanation
(3b) CSF protein > 50 mg/dL without an alternative explanation
(3c) reactive CSF VDRL (Venereal Disease Research Laboratory) result
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