...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>International journal of infectious diseases : >Neurosyphilis: Concordance between cerebrospinal fluid analysis and subsequent antibiotic strategy for patients undergoing evaluation of a diagnosis of neurosyphilis
【24h】

Neurosyphilis: Concordance between cerebrospinal fluid analysis and subsequent antibiotic strategy for patients undergoing evaluation of a diagnosis of neurosyphilis

机译：神经性梅毒：接受神经性梅毒诊断评估的患者的脑脊液分析与后续抗生素策略之间的一致性

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Introduction The confirmation or analysis and exclusion of a diagnosis of neurosyphilis has long presented a challenge for infectious diseases clinicians. The authors reviewed the concordance between cerebrospinal fluid (CSF) analysis and the subsequent antibiotic strategy for patients undergoing evaluation of a diagnosis of neurosyphilis. Methods All patients with positive serum syphilis serology referred for CSF analysis between January 2009 and May 2016 were included. Indications for CSF analysis were determined by review of the hospital electronic medical records. CSF parameters were determined from the hospital pathology database. Cases were defined as either ‘confirmed’, ‘supportive’ of, or ‘not supportive’ of a diagnosis of neurosyphilis based on existing definitions. Subsequent therapy was defined as for neurosyphilis, late latent primary syphilis or no therapy based on existing guidelines. Results Of 131 patients reviewed, 95.4% were male and HIV co-infected (74%). A confirmed diagnosis of neurosyphilis was met by fourteen patients (10.7%). All but two of these were treated with a neurosyphilis-directed regimen. Of the 58 patients treated with neurosyphilis antibiotics, 17.2% had no CSF findings suggestive of the diagnosis. Seventy-three patients were not treated for neurosyphilis; however 35 of these met the CSF criteria for a diagnosis supportive of neurosyphilis. Conclusions The results of routine CSF analysis in patients with a possible diagnosis of neurosyphilis are inconsistently applied in the clinical setting, calling into question the value of routine CSF. Empirical neurosyphilis treatment should be considered up front in patients with high pre-test probability of the diagnosis.
机译：引言对神经梅毒的诊断进行确认或分析以及排除，一直是传染病临床医生面临的挑战。作者回顾了脑脊液（CSF）分析与随后对接受神经梅毒诊断评估的患者的抗生素策略之间的一致性。方法纳入2009年1月至2016年5月期间接受脑脊液分析的所有血清梅毒血清学阳性的患者。通过检查医院电子病历来确定脑脊液分析的指征。 CSF参数是从医院病理数据库中确定的。根据现有定义，病例被定义为对神经梅毒的诊断为“证实”，“支持”或“不支持”。根据现有指南，将随后的治疗定义为神经梅毒，晚期潜伏性原发性梅毒或不进行治疗。结果131例患者中，男性和HIV合并感染率为95.4％（74％）。确诊为神经梅毒的诊断为14例患者（10.7％）。除两个以外，所有其他患者均接受神经梅毒定向治疗。在接受神经梅毒抗生素治疗的58例患者中，有17.2％的患者没有脑脊液检查提示诊断。 73例患者未接受神经梅毒治疗;然而，其中35个符合CSF诊断支持神经梅毒的标准。结论在可能诊断为神经梅毒的患者中，常规CSF分析的结果在临床环境中应用不一致，这使常规CSF的价值受到质疑。对于诊断前可能性高的患者，应考虑经验性神经梅毒治疗。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号