We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Lumbar Puncture in the Treatment of Neurosyphilis-Reply

Joseph Wiesel, MD; David N. Rose, MD; Alan L. Silver, MD, MPH; Henry S. Sacks, PhD, MD; Richard H. Bernstein, MD
Arch Intern Med. 1986;146(2):412. doi:10.1001/archinte.1986.00360140268041.
Text Size: A A A
Published online


Dr Wolters' finding of such a high proportion (23%) of neurosyphilis among those with asymptomatic late syphilis is notable. This is higher than other studies, even those performed prior to the widespread use of antibiotic therapy, which generally found the proportion to be around 10%. Based on studies performed in this country after the introduction of antibiotics, we estimate this proportion to be less than 5%. The difference in Dr Wolters' study and the current estimate may be one of definition. The studies on which we based current estimates did not include people with dizziness or headaches. If Dr Wolter's population truly has such a high prevalence, then a routine cerebrospinal fluid (CSF) examination should be performed.

The antibody test used by Dr Wolters is not available to most physicians. Furthermore, CSF treponemal antibody tests have low specificity; therefore, only reagin tests are used for CSF analysis in this country.1


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.