Neurosyphilis screening: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Neurosyphilis}} | |||
{{CMG}} {{AE}} {{MMJ}} | {{CMG}} {{AE}} {{MMJ}} | ||
{{neuroyphilis}} | {{neuroyphilis}} | ||
==Overview== | ==Overview== | ||
Screening guidelines for syphilis include all high risk non-pregnant individuals aged 15-65, all pregnant females, men who have sex with men, women who have sex with women, and [[Human Immunodeficiency Virus (HIV)|HIV]] positive individuals. | Screening guidelines for syphilis include all high risk non-pregnant individuals aged 15-65, all pregnant females, men who have sex with men, women who have sex with women, and [[Human Immunodeficiency Virus (HIV)|HIV]] positive individuals. Routine screening of adolescents who are asymptomatic for syphilis is not recommended. | ||
==Screening== | ==Screening== | ||
[[Screening]] guidelines for syphilis are: | [[Screening]] guidelines for syphilis are:<ref name="cdc5">http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016</ref><ref name="USPTF4">https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016</ref> | ||
===Non-pregnant adults and adolescents (age 15-65)=== | ====Non-pregnant adults and adolescents (age 15-65)==== | ||
*All individuals who are at increased risk for syphilis should be screened for syphilis [[United states preventive services task force recommendations scheme#USPSTF Grade Definitions|Grade A recommendation]].<ref name= sypilis>https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents?ds=1&s=syphilis Accessed on September 19, 2016</ref><ref name="pmid27272583">{{cite journal| author=US Preventive Services Task Force (USPSTF). Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW et al.| title=Screening for Syphilis Infection in Nonpregnant Adults and Adolescents: US Preventive Services Task Force Recommendation Statement. | journal=JAMA | year= 2016 | volume= 315 | issue= 21 | pages= 2321-7 | pmid=27272583 | doi=10.1001/jama.2016.5824 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27272583 }} </ref> | *Routine screening of adolescents who are asymptomatic for syphilis is not recommended.<ref name="cdc5" /><ref name="sypilis">https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents?ds=1&s=syphilis Accessed on September 19, 2016</ref> | ||
* | *All individuals who are at increased risk for syphilis should be screened for syphilis [[United states preventive services task force recommendations scheme#USPSTF Grade Definitions|Grade A recommendation]].<ref name="sypilis">https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents?ds=1&s=syphilis Accessed on September 19, 2016</ref><ref name="pmid27272583">{{cite journal| author=US Preventive Services Task Force (USPSTF). Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW et al.| title=Screening for Syphilis Infection in Nonpregnant Adults and Adolescents: US Preventive Services Task Force Recommendation Statement. | journal=JAMA | year= 2016 | volume= 315 | issue= 21 | pages= 2321-7 | pmid=27272583 | doi=10.1001/jama.2016.5824 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27272583 }} </ref> | ||
*High risk populations which require frequent screening include:<ref name="USPTF4" /> | |||
**Uninsured women | |||
**Women living in poverty | |||
**Sex workers | |||
**[[Drug abuse|Illicit drug users]] | |||
**Presence of other sexually transmitted diseases ([[Sexually transmitted disease|STDs]]) | |||
**Other women living in communities with high syphilis morbidity | |||
===Pregnant women=== | ====Pregnant women==== | ||
*At first [[Prenatal|prenatal visit]]<ref name=CDC4>http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref> | *At first [[Prenatal|prenatal visit]]<ref name="CDC4">http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref> | ||
*Retest at early [[third trimester]] and delivery if high risk<ref name=USPTF4> https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016</ref> | *Retest at early [[third trimester]] and delivery if high risk<ref name="USPTF4">https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016</ref> | ||
====Men who have sex with men==== | |||
*Annually for sexually active men who have sex with men<ref name="CDC4">http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref> | |||
===Men who have sex with men=== | |||
*Annually for sexually active men who have sex with men<ref name=CDC4>http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref> | |||
*Every 3 to 6 months if increased risk | *Every 3 to 6 months if increased risk | ||
===Women who have sex with women=== | ====Women who have sex with women==== | ||
*Routine screening is recommended<ref name=cdc5>http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016</ref> | *Routine screening is recommended<ref name="cdc5">http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016</ref> | ||
===HIV positive individuals=== | ====HIV positive individuals==== | ||
*At first [[HIV]] evaluation for sexually active individuals<ref name=CDC4>http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref><ref name=lancet> http://hivprevent.thelancet.com/content/guidelines-and-recommendations Accesed on September 19, 2016</ref> | *At first [[HIV]] evaluation for sexually active individuals<ref name="CDC4">http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016</ref><ref name="lancet">http://hivprevent.thelancet.com/content/guidelines-and-recommendations Accesed on September 19, 2016</ref> | ||
*Annually after first evaluation | *Annually after first evaluation | ||
*More frequent testing for individuals who are at increased risk or are residing in highly prevalent areas of syphilis | *More frequent testing for individuals who are at increased risk or are residing in highly prevalent areas of syphilis | ||
==Screening tests== | ==Screening tests== | ||
Screening tests recommended for syphilis include the following:<ref name= UPTFS2>https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/syphilis-infection-in-pregnancy-screening Accessed on September 19, 2016</ref> | Screening tests recommended for syphilis include the following:<ref name="UPTFS2">https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/syphilis-infection-in-pregnancy-screening Accessed on September 19, 2016</ref> | ||
===Screening non-treponemal tests=== | ===Screening non-treponemal tests=== | ||
*[[Venereal Disease Research Laboratory]] ([[VDRL]])<ref name="pmid18159528">{{cite journal| author=Ratnam S| title=The laboratory diagnosis of syphilis. | journal=Can J Infect Dis Med Microbiol | year= 2005 | volume= 16 | issue= 1 | pages= 45-51 | pmid=18159528 | doi= | pmc=2095002 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18159528 }} </ref> | *[[Venereal Disease Research Laboratory]] ([[VDRL]])<ref name="pmid18159528">{{cite journal| author=Ratnam S| title=The laboratory diagnosis of syphilis. | journal=Can J Infect Dis Med Microbiol | year= 2005 | volume= 16 | issue= 1 | pages= 45-51 | pmid=18159528 | doi= | pmc=2095002 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18159528 }} </ref> | ||
*[[Rapid Plasma Reagin]]([[RPR]])<ref name="pmid7704889">{{cite journal| author=Larsen SA, Steiner BM, Rudolph AH| title=Laboratory diagnosis and interpretation of tests for syphilis. | journal=Clin Microbiol Rev | year= 1995 | volume= 8 | issue= 1 | pages= 1-21 | pmid=7704889 | doi= | pmc=172846 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7704889 }} </ref> | *[[Rapid Plasma Reagin]]([[RPR]])<ref name="pmid7704889">{{cite journal| author=Larsen SA, Steiner BM, Rudolph AH| title=Laboratory diagnosis and interpretation of tests for syphilis. | journal=Clin Microbiol Rev | year= 1995 | volume= 8 | issue= 1 | pages= 1-21 | pmid=7704889 | doi= | pmc=172846 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7704889 }} </ref> | ||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2] Template:Neuroyphilis
Overview
Screening guidelines for syphilis include all high risk non-pregnant individuals aged 15-65, all pregnant females, men who have sex with men, women who have sex with women, and HIV positive individuals. Routine screening of adolescents who are asymptomatic for syphilis is not recommended.
Screening
Screening guidelines for syphilis are:[1][2]
Non-pregnant adults and adolescents (age 15-65)
- Routine screening of adolescents who are asymptomatic for syphilis is not recommended.[1][3]
- All individuals who are at increased risk for syphilis should be screened for syphilis Grade A recommendation.[3][4]
- High risk populations which require frequent screening include:[2]
- Uninsured women
- Women living in poverty
- Sex workers
- Illicit drug users
- Presence of other sexually transmitted diseases (STDs)
- Other women living in communities with high syphilis morbidity
Pregnant women
- At first prenatal visit[5]
- Retest at early third trimester and delivery if high risk[2]
Men who have sex with men
- Annually for sexually active men who have sex with men[5]
- Every 3 to 6 months if increased risk
Women who have sex with women
- Routine screening is recommended[1]
HIV positive individuals
- At first HIV evaluation for sexually active individuals[5][6]
- Annually after first evaluation
- More frequent testing for individuals who are at increased risk or are residing in highly prevalent areas of syphilis
Screening tests
Screening tests recommended for syphilis include the following:[7]
Screening non-treponemal tests
References
- ↑ 1.0 1.1 1.2 http://www.cdc.gov/std/treatment/2010/specialpops.htm Accessed on September 19, 2016
- ↑ 2.0 2.1 2.2 https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016
- ↑ 3.0 3.1 https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents?ds=1&s=syphilis Accessed on September 19, 2016
- ↑ US Preventive Services Task Force (USPSTF). Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW; et al. (2016). "Screening for Syphilis Infection in Nonpregnant Adults and Adolescents: US Preventive Services Task Force Recommendation Statement". JAMA. 315 (21): 2321–7. doi:10.1001/jama.2016.5824. PMID 27272583.
- ↑ 5.0 5.1 5.2 http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016
- ↑ http://hivprevent.thelancet.com/content/guidelines-and-recommendations Accesed on September 19, 2016
- ↑ https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/syphilis-infection-in-pregnancy-screening Accessed on September 19, 2016
- ↑ Ratnam S (2005). "The laboratory diagnosis of syphilis". Can J Infect Dis Med Microbiol. 16 (1): 45–51. PMC 2095002. PMID 18159528.
- ↑ Larsen SA, Steiner BM, Rudolph AH (1995). "Laboratory diagnosis and interpretation of tests for syphilis". Clin Microbiol Rev. 8 (1): 1–21. PMC 172846. PMID 7704889.