Diagnosis of neurosyphilis with cerebrospinal fluid pcr: a systematic review
Autor(a) principal: | |
---|---|
Data de Publicação: | 2022 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Jornal Brasileiro de Patologia e Medicina Laboratorial (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-24442022000100301 |
Resumo: | ABSTRACT Background Neurosyphilis is difficult to be diagnosed. CSF VDRL is the gold standard, but its sensitivity is low. Cerebrospinal fluid (CSF) PCR for the detection of Treponema pallidum DNA has been evaluated; however, its diagnostic value is still poorly understood. Methods Here we performed a systematic review including articles that assessed the diagnostic sensitivity of CSF PCR in patients with syphilis and neurosyphilis. The CSF PCR sensitivity and specificity of different PCR assays was assessed in patients with neurosyphilis with or without HIV coinfection and in patients with syphilis with no central nervous system (CNS) manifestations. Results Eighteen studies evaluating 703 patients were included. The PCR sensitivity for neurosyphilis was 73.9% among HIV negative and 37.5% among HIV infected patients, having varied from 62.2% to 100% with different PCR assays. The sensitivity of CSF VDRL CSF was 68% in the same population. The specificity of CSF PCR was 93%. CSFPCR was positive in16.4% of the patients with primary and secondary syphilisand 28.9% of patients with latent syphilis. None of the syphilis cases without neurological manifestations were positive with CSF VDRL. Conclusion CSF PCR seems to be at least as sensitive as CSF VDRL, with good specificity. In addition, CSF PCR may potentially reveal early neuroinvasion in patients withsyphilis with no CNS symptoms. Future studies are still needed to assess the potential clinical value of detecting T. pallidum DNA in CSF in syphilis cases prior to the development of CNS symptoms. |
id |
SBP-1_a39c2828dd8d67dc33e4d70b2ff4a303 |
---|---|
oai_identifier_str |
oai:scielo:S1676-24442022000100301 |
network_acronym_str |
SBP-1 |
network_name_str |
Jornal Brasileiro de Patologia e Medicina Laboratorial (Online) |
repository_id_str |
|
spelling |
Diagnosis of neurosyphilis with cerebrospinal fluid pcr: a systematic reviewneurosyphilissyphiliscerebrospinal fluidpolymerase chain reaction (pcrABSTRACT Background Neurosyphilis is difficult to be diagnosed. CSF VDRL is the gold standard, but its sensitivity is low. Cerebrospinal fluid (CSF) PCR for the detection of Treponema pallidum DNA has been evaluated; however, its diagnostic value is still poorly understood. Methods Here we performed a systematic review including articles that assessed the diagnostic sensitivity of CSF PCR in patients with syphilis and neurosyphilis. The CSF PCR sensitivity and specificity of different PCR assays was assessed in patients with neurosyphilis with or without HIV coinfection and in patients with syphilis with no central nervous system (CNS) manifestations. Results Eighteen studies evaluating 703 patients were included. The PCR sensitivity for neurosyphilis was 73.9% among HIV negative and 37.5% among HIV infected patients, having varied from 62.2% to 100% with different PCR assays. The sensitivity of CSF VDRL CSF was 68% in the same population. The specificity of CSF PCR was 93%. CSFPCR was positive in16.4% of the patients with primary and secondary syphilisand 28.9% of patients with latent syphilis. None of the syphilis cases without neurological manifestations were positive with CSF VDRL. Conclusion CSF PCR seems to be at least as sensitive as CSF VDRL, with good specificity. In addition, CSF PCR may potentially reveal early neuroinvasion in patients withsyphilis with no CNS symptoms. Future studies are still needed to assess the potential clinical value of detecting T. pallidum DNA in CSF in syphilis cases prior to the development of CNS symptoms.Sociedade Brasileira de Patologia Clínica2022-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-24442022000100301Jornal Brasileiro de Patologia e Medicina Laboratorial v.58 2022reponame:Jornal Brasileiro de Patologia e Medicina Laboratorial (Online)instname:Sociedade Brasileira de Patologia (SBP)instacron:SBP10.1900/jbpml.2022.58.443info:eu-repo/semantics/openAccessDomingues,Renan BarrosGiafferi,Carlos Alberto SalzedasSantos,Márcio Vega dosLeite,Fernando Brunale Vilela de MouraSenne,Carloseng2022-05-26T00:00:00Zoai:scielo:S1676-24442022000100301Revistahttp://www.scielo.br/jbpmlhttps://old.scielo.br/oai/scielo-oai.php||jbpml@sbpc.org.br1678-47741676-2444opendoar:2022-05-26T00:00Jornal Brasileiro de Patologia e Medicina Laboratorial (Online) - Sociedade Brasileira de Patologia (SBP)false |
dc.title.none.fl_str_mv |
Diagnosis of neurosyphilis with cerebrospinal fluid pcr: a systematic review |
title |
Diagnosis of neurosyphilis with cerebrospinal fluid pcr: a systematic review |
spellingShingle |
Diagnosis of neurosyphilis with cerebrospinal fluid pcr: a systematic review Domingues,Renan Barros neurosyphilis syphilis cerebrospinal fluid polymerase chain reaction (pcr |
title_short |
Diagnosis of neurosyphilis with cerebrospinal fluid pcr: a systematic review |
title_full |
Diagnosis of neurosyphilis with cerebrospinal fluid pcr: a systematic review |
title_fullStr |
Diagnosis of neurosyphilis with cerebrospinal fluid pcr: a systematic review |
title_full_unstemmed |
Diagnosis of neurosyphilis with cerebrospinal fluid pcr: a systematic review |
title_sort |
Diagnosis of neurosyphilis with cerebrospinal fluid pcr: a systematic review |
author |
Domingues,Renan Barros |
author_facet |
Domingues,Renan Barros Giafferi,Carlos Alberto Salzedas Santos,Márcio Vega dos Leite,Fernando Brunale Vilela de Moura Senne,Carlos |
author_role |
author |
author2 |
Giafferi,Carlos Alberto Salzedas Santos,Márcio Vega dos Leite,Fernando Brunale Vilela de Moura Senne,Carlos |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Domingues,Renan Barros Giafferi,Carlos Alberto Salzedas Santos,Márcio Vega dos Leite,Fernando Brunale Vilela de Moura Senne,Carlos |
dc.subject.por.fl_str_mv |
neurosyphilis syphilis cerebrospinal fluid polymerase chain reaction (pcr |
topic |
neurosyphilis syphilis cerebrospinal fluid polymerase chain reaction (pcr |
description |
ABSTRACT Background Neurosyphilis is difficult to be diagnosed. CSF VDRL is the gold standard, but its sensitivity is low. Cerebrospinal fluid (CSF) PCR for the detection of Treponema pallidum DNA has been evaluated; however, its diagnostic value is still poorly understood. Methods Here we performed a systematic review including articles that assessed the diagnostic sensitivity of CSF PCR in patients with syphilis and neurosyphilis. The CSF PCR sensitivity and specificity of different PCR assays was assessed in patients with neurosyphilis with or without HIV coinfection and in patients with syphilis with no central nervous system (CNS) manifestations. Results Eighteen studies evaluating 703 patients were included. The PCR sensitivity for neurosyphilis was 73.9% among HIV negative and 37.5% among HIV infected patients, having varied from 62.2% to 100% with different PCR assays. The sensitivity of CSF VDRL CSF was 68% in the same population. The specificity of CSF PCR was 93%. CSFPCR was positive in16.4% of the patients with primary and secondary syphilisand 28.9% of patients with latent syphilis. None of the syphilis cases without neurological manifestations were positive with CSF VDRL. Conclusion CSF PCR seems to be at least as sensitive as CSF VDRL, with good specificity. In addition, CSF PCR may potentially reveal early neuroinvasion in patients withsyphilis with no CNS symptoms. Future studies are still needed to assess the potential clinical value of detecting T. pallidum DNA in CSF in syphilis cases prior to the development of CNS symptoms. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-24442022000100301 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-24442022000100301 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1900/jbpml.2022.58.443 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Patologia Clínica |
publisher.none.fl_str_mv |
Sociedade Brasileira de Patologia Clínica |
dc.source.none.fl_str_mv |
Jornal Brasileiro de Patologia e Medicina Laboratorial v.58 2022 reponame:Jornal Brasileiro de Patologia e Medicina Laboratorial (Online) instname:Sociedade Brasileira de Patologia (SBP) instacron:SBP |
instname_str |
Sociedade Brasileira de Patologia (SBP) |
instacron_str |
SBP |
institution |
SBP |
reponame_str |
Jornal Brasileiro de Patologia e Medicina Laboratorial (Online) |
collection |
Jornal Brasileiro de Patologia e Medicina Laboratorial (Online) |
repository.name.fl_str_mv |
Jornal Brasileiro de Patologia e Medicina Laboratorial (Online) - Sociedade Brasileira de Patologia (SBP) |
repository.mail.fl_str_mv |
||jbpml@sbpc.org.br |
_version_ |
1752122297917898752 |