Syphilis detection in cerebrovascular disease

To determine the importance of syphilis testing in cerebrovascular disease, we prospectively assessed 218 consecutive patients with either transient ischemic attack or completed stroke. The results from this study group were compared with those from a control group of 150 neurological patients witho...

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Bibliographic Details
Published in:Stroke (1970) 1989-02, Vol.20 (2), p.230-234
Main Authors: KELLEY, R. E, BELL, L, KELLEY, S. E, SHIH-CHANG LEE
Format: Article
Language:English
Subjects:
AIDS/HIV
Biological and medical sciences
Cerebrospinal Fluid - cytology
Cerebrospinal Fluid - metabolism
Cerebrovascular Disorders - complications
Fluorescent Antibody Technique
Humans
Male
Medical sciences
Middle Aged
Neurology
Syphilis - complications
Syphilis - diagnosis
Syphilis Serodiagnosis
Vascular diseases and vascular malformations of the nervous system
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Summary:To determine the importance of syphilis testing in cerebrovascular disease, we prospectively assessed 218 consecutive patients with either transient ischemic attack or completed stroke. The results from this study group were compared with those from a control group of 150 neurological patients without cerebrovascular disease. Of 275 patients from both groups specifically tested by the fluorescent treponemal antibody-absorption test, 34% of the study group were seropositive compared with 18% of the controls (chi 2 = 7.7, p less than 0.01). Fifty-four percent of the patients with a positive fluorescent treponemal antibody-absorption test underwent a cerebrospinal fluid examination; meningovascular syphilis was detected in one (0.4%) of these. This patient was a homosexual male with antibodies to the human immunodeficiency virus; a second patient, with possible meningovascular syphilis, also had antibodies to this virus. Despite the relatively high rate of syphilis seropositivity noted in our study group, syphilis was not found to be a common cause of cerebrovascular disease; therefore, routine screening is seen to be of low diagnostic yield. Attention to patients who are at higher risk for syphilitic infection, patients with clinical features suggestive of meningovascular syphilis, and the proper choice of serologic studies can help make the assessment of syphilis seropositivity more clinically appropriate and cost effective.
ISSN:0039-2499
1524-4628
DOI:10.1161/01.STR.20.2.230