Neurosyphilis: Description of a series of cases and review of the literature in Spain

Introduction: Neurosyphilis occurs at any stage of development. Most cases are asymptomatic, although they may present different symptomatology. Its incidence seems to have increased. Diagnosis requires the study of cerebrospinal fluid (CSF), together with clinical and serological findings. The treatment of choice is still Penicillin G sodium. Methods: Work in two phases i) review of neurosyphilis cases from the University Hospital of Salamanca (HUS) between 2004 and 2021. ii) Systematic review using the PRISMA method of neurosyphilis series published in Spain from 1990-2021. Results: 34 HUS patients were analyzed. 85.3% were men with an average age of 53 years. 50% were HIV+. Headache was the most common symptom. In a systematic review, a total of 121 cases were analyzed, of which 92.4% of the patients were men between 35 and 50 years old. Furthermore, 87.1% of the subjects were men who had sex with men and 71.6% were HIV+. The treatment most frequently used in patients was Penicillin G. Discussion: A change is observed in the clinical pattern, with asymptomatic and early forms becoming more frequent compared to late ones. Half of the patients with suspected neurosyphilis present VDRL positivity in the CSF, the rest of the patients were diagnosed by clinical symptoms and RPR titers. The treatment used coincides with clinical guidelines.