Diagnosis of neurosyphilis with cerebrospinal fluid pcr: a systematic review

Detalhes bibliográficos
Autor(a) principal: Domingues,Renan Barros
Data de Publicação: 2022
Outros Autores: Giafferi,Carlos Alberto Salzedas, Santos,Márcio Vega dos, Leite,Fernando Brunale Vilela de Moura, Senne,Carlos
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.
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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
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1900/jbpml.2022.58.443
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Sociedade Brasileira de Patologia Clínica
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Sociedade Brasileira de Patologia Clínica
dc.source.none.fl_str_mv Jornal Brasileiro de Patologia e Medicina Laboratorial v.58 2022
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