Neurosyphilis in the Northern Territory of Australia: a clinical guideline

• Published in: Internal medicine journal Vol. 53; no. 5; pp. 738 - 744
• Main Authors: Birrell, Johanna Marie, Lowe, Michael, Gunathilake, Manoji, Krause, Vicki Lynn
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.05.2023; Wiley Subscription Services, Inc
• Subjects: Dementia; Dementia disorders; Differential diagnosis; Epidemiology; Humans; neurology; Neurosyphilis; Neurosyphilis - diagnosis; Northern Territory; Patients; Syphilis; Syphilis - diagnosis; Syphilis Serodiagnosis; Northern Territory; syphilis; neurosyphilis; neurology
• ISSN: 1444-0903; 1445-5994; 1445-5994
• DOI: 10.1111/imj.15691

Background The Northern Territory (NT) of Australia is currently experiencing a syphilis epidemic. Neurosyphilis is commonly considered in the differential diagnosis for patients presenting with neurologic conditions such as dementia and stroke in the NT. Aims To explore the local epidemiologic, diagnostic and treatment complexities of neurosyphilis in the NT and produce a guideline for clinical practice. Methods A database search was undertaken and local and global neurosyphilis guidelines were analysed. A guideline was created based on findings of the critical review and consultation with local multidisciplinary experts. Results Neurosyphilis is frequently encountered in the NT but studies suggest it is often undertreated. Dementia is the most common clinical presentation locally. Establishing a diagnosis of neurosyphilis is complex and requires stepwise evaluation of clinical, laboratory and radiological findings. Conclusions A clinical guideline and algorithm have been developed for the diagnosis and management of patients with neurosyphilis.