TABLE.
Characteristics of symptomatic early neurosyphilis cases* among HIV-positive men who have sex with men. by syndrome — four U.S. cities,† January 2002–June 2004
| Syndrome§ | Cases | Median no. of hospital days | Median CD4 count (cells/mm3)¶ | Median HIV viral load (copies/mL)¶ | Median no. of days from symptom onset to start of treatment | Cases in patients with persistent symptoms 6 months after treatment** | ||
|---|---|---|---|---|---|---|---|---|
| No. | (%) | No. of cases/No. of patients | (%) | |||||
| Cranial nerve dysfunction | ||||||||
| Ocular | 25 | (51.0) | 6 | 376 | 28,100 | 26 | 6/19 | (31.6) |
| Auditory | 6 | (12.2 | 6 | 322 | 31,072 | 24 | 2/4 | (50.0) |
| Ocular and auditory | 1 | (2.0) | 17 | 345 | 866 | 34 | 1/1 | (100.0) |
| Other | 2 | (4.1) | 1 | 14 | —†† | 86 | 0/1 | (0.0) |
| Meningitis | ||||||||
| Acute meningitis | 6 | (12.2) | 7 | 446 | 10,020 | 27 | 1/6 | (16.7) |
| Meningovascular syndrome | ||||||||
| Cerebrovascular accident | 2 | (4.1) | 11 | 66 | 1,350 | 5 | 1/2 | (50.0) |
| Other syndromes | ||||||||
| Headache, altered mental status, or both | 7 | (14.3) | 14 | 148 | 24,784 | 16 | 0/4 | (0.0) |
| Overall | 49 | (100.0) | 7 | 312 | 27,570 | 25 | 11/37 | (29.7) |
Information on ODC’s surveillance case definition for neurosyphilis is available at http://www.odc.gov/std/syphsurvrcoo.pdf. Confirmed: syphilis of any stage, a reactive serologic test for syphilis, and a reactive Vanereal Disease Research Laboratory (VDRL) test in cerebrospinal fluid (CSF). Probable: syphilis of any stage, a nonreactive VDRL test in CSF, and both of the following: 1) elevated CSF protein (>40 mg/dL) or leukocyte count (>5 cell/mm3) in the absence of other known causes of these abnormalities and 2) clinical symptoms or signs consistent with neurosyphilis in the absence of other known causes of these abnormalities.
Los Angeles, California; San Diego, California; Chicago, Illinois; and New York, New York.
Syndrome classification definitions: ocular (inflammation of ocular tissue [e.g., uveitis, retinitis, or optic neuritis]), auditory (e.g., decreased hearing or tinnitus), other cranial nerves (e.g., diplopia or imbalance), acute meningitis (e.g., fever or meningismus), and other syndromes that were thought by the clinician to be manifestations of neurosyphilis.
Measure obtained closest to date of diagnosis within the period 45 days before to 15 days after that date.
Denominators based on 37 patients for whom 6-month follow-up was available; three patients with ocular neurosyphilis had a symptomatic neurosyphilis relapse after appropriate treatment and were not included in the persistent symptoms analysis.
Data not available.