Neurosyphilis: Descriptive analysis of clinical presentation, diagnosis, treatment, and outcomes

Given the increased incidence of syphilis in Spain, the objective is to analyze the clinical presentation, diagnosis, treatment, and outcomes of neurosyphilis cases managed in our unit.

Retrospective descriptive study (2012-2023) including patients older than 14 years classified as early, late, or asymptomatic clinical forms. Demographic, clinical, and outcome variables were analyzed.

Seventeen cases were included (94.1% male), with HIV coinfection in 29.4%. The predominant forms were syphilitic dementia and ocular syphilis (29.4%). Detection of CSF RPR (Rapid Plasma Reagin) was positive in 64.2%. Intravenous penicillin G was administered in 82.3% of cases; two early forms had been treated with intramuscular penicillin. Clinical improvement was observed in 47.1% of patients.

An increase in neurosyphilis cases was observed, with acceptable CSF RPR sensitivity. Early forms showed a better prognosis, highlighting the need for clinical follow-up due to the possibility of symptomatic relapses.