International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
International comparison of neurosyphilis-related guidance for lumbar puncture, CSF interpretation, treatment, and follow-up: a systematic review.
СтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zhang Wei, Fan Shu-Hao, Zheng Ying, Wang Cheng, Tong Man-Li, Lin Li-Rong
Аннотация
OBJECTIVES: To compare international neurosyphilis guidance across lumbar puncture (LP), cerebrospinal fluid (CSF) interpretation, treatment, and follow-up.
METHODS: We searched PubMed, Embase, Web of Science Core Collection, Scopus, and official sources for guidance documents containing adult neurosyphilis recommendations, published or updated from January 1, 2003, through September 2, 2026. Two reviewers independently coded clinical recommendations, and four appraisers independently assessed guideline quality using AGREE II.
RESULTS: Thirty-two guidance sets were included. Preferred penicillin therapy was specified in 29/32 (90.6%) and serologic follow-up in 30/32 (93.8%). LP was recommended for neurologic presentations in 25/32 (78.1%), but for ocular and otic syphilis in 14/32 (43.8%) each; none recommended LP solely for a high serum nontreponemal titre or HIV infection. CSF nontreponemal and treponemal testing were addressed in 21/32 (65.6%) and 18/32 (56.3%). CSF white blood cell count and protein were each mentioned in 22/32 (68.8%), whereas explicit adult numeric thresholds were provided in 14/32 (43.8%) and 9/32 (28.1%). Repeat CSF assessment was recommended in 12/32 (37.5%) and conditionally recommended in 8/32 (25.0%). Median AGREE II scores were highest for clarity of presentation (89.6%) and scope and purpose (82.6%) and lowest for editorial independence (35.4%) and rigour of development (41.1%).
CONCLUSIONS: Penicillin-based preferred regimens were widely specified, whereas guidance remained heterogeneous for LP decisions, CSF interpretation, and post-treatment monitoring. For ocular or otic syphilis, recommendations for neurosyphilis-level treatment should be distinguished from recommendations for baseline LP.
METHODS: We searched PubMed, Embase, Web of Science Core Collection, Scopus, and official sources for guidance documents containing adult neurosyphilis recommendations, published or updated from January 1, 2003, through September 2, 2026. Two reviewers independently coded clinical recommendations, and four appraisers independently assessed guideline quality using AGREE II.
RESULTS: Thirty-two guidance sets were included. Preferred penicillin therapy was specified in 29/32 (90.6%) and serologic follow-up in 30/32 (93.8%). LP was recommended for neurologic presentations in 25/32 (78.1%), but for ocular and otic syphilis in 14/32 (43.8%) each; none recommended LP solely for a high serum nontreponemal titre or HIV infection. CSF nontreponemal and treponemal testing were addressed in 21/32 (65.6%) and 18/32 (56.3%). CSF white blood cell count and protein were each mentioned in 22/32 (68.8%), whereas explicit adult numeric thresholds were provided in 14/32 (43.8%) and 9/32 (28.1%). Repeat CSF assessment was recommended in 12/32 (37.5%) and conditionally recommended in 8/32 (25.0%). Median AGREE II scores were highest for clarity of presentation (89.6%) and scope and purpose (82.6%) and lowest for editorial independence (35.4%) and rigour of development (41.1%).
CONCLUSIONS: Penicillin-based preferred regimens were widely specified, whereas guidance remained heterogeneous for LP decisions, CSF interpretation, and post-treatment monitoring. For ocular or otic syphilis, recommendations for neurosyphilis-level treatment should be distinguished from recommendations for baseline LP.