Submit Manuscript | http://medcraveonline.com Introduction Syphilis is a sexually transmitted infection currently on the rise. The causative agent is a spirochete, Treponema pallidum, which in the absence of treatment can invade the central nervous system and its envelopes by creating a strong chronic infammatory reaction: it is neurosyphilis that present the most severe neurological complication of syphilis active. Materials and methods A retrospective study of 30patients with Neurosyphilis over a period of 10years (from January 2006 to December 2016). The criteria for the inclusion of neurological manifestations, evocative imaging, the positivity of syphilitic serology (VDRL and TPHA) in cerebrospinal fuid (CSF) and blood. The data was collected by an exploitation sheet. Results The average age of our patients is 48years. All our patients are male. The average consultation period is 1.5years. The history of syphilitic chancre was found in 10 of the young. The mean time to onset of Neurosyphilis after the chancre was 12years. Most patients (46%) are referred by a psychiatrist, 20% are referred by their families, and 20% are referred by an ophthalmologist, while 12.5% are referred by a primary care physician. 13 cases (43%) were consulted for epilepticus status, 7 cases (23%) presented for dementia, 6patients (20%) had bilateral blindness and 3 other neurological symptoms, and one case of cerebrovascular syphilis (Table 1). Human Immunodefciency Virus (HIV) serology is negative for all of our patients. We realized on the CSF, a cytochemical examination with white and red blood cell count, protein and glucose assay on CSF and serum, VDRL and TPHA tests for the detection of specifc antibodies. The CSF study showed 6 cases (20%) of meningitis with a variant of cytology between 20 and 890elements/ml predominantly lymphocyte. 40% of cases have hyperproteinorrachia with extremes of 0.6 and 4.3g/l, glycorrhachia was normal in all cases. The initial titration of VDRL and TPHA was respectively positive in 18 cases (60%) and 22 cases (74%) in the CSF, and in 20 cases (67%) and 26 cases (87%) in the serum (Table 2). All patients were treated with intravenous penicillin G. Eighteen patients were cured with a two-year follow-up. Six patients are still being referred to the neurology department. Three patients were lost to follow-up. Despite the treatment, the evolution was towards a general paralysis with the deaths of three patients. MOJ Clin Med Case Rep. 2017;7(4):280‒283. 280 © 2017 Zineb et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Biological diagnosis and monitoring of neurosyphilis: study of cerebrospinal fuid in 30 cases Volume 7 Issue 4 - 2017 Taki Imrani Zineb, 1 Mahha Mariam, 1 Hendi Rajae, 1 Yahyaoui Ghita, 1 Mahmoud Mustapha, 1 Benbrahim Fouzia, 2 Belahsen Mohammed Faouzi 2 1 Department of microbiology, universitary hospital Hassan II, Morocco 2 Department of neurology, universitary hospital Hassan II, Morocco Correspondence: Taki Imrani Zineb, Department of microbiology, universitary hospital Hassan II, 30000 Fes, Morocco, Email zinebtaki1988@gmail.com Received: July 30, 2017 | Published: October 30, 2017 Abstract Aim: identify the most informative cerebrospinal fluid (CSF) markers in the diagnosis of active neurosyphilis and in surveillance during antibiotic treatment. Type of study: retrospective, analytical, epidemiological study over a period of 10years, from 1 January 2006 to 31 December 2016 conducted in the laboratory of microbiology of CHU HASSAN II of Fez. Patients and methods: We have identified 30 cases of neurosyphilis over a 10-year period. All patients were HIV negative. We realised on the CSF, a cytochemical examination, white and red blood cell count, a total protein and glucose levels on CSF and serum, VDRL and TPHA tests for the detection of specific antibodies. Results: The CSF study showed 6 cases (20%) of meningitis with cytology varying between 20 and 890cells/ml predominantly lymphocytic. 40% of cases had hyper- proteinuria with extremes 0.2 and 4.3g/l, glycorachia was normal in all cases. The initial titration of VDRL and TPHA was positive in 18 (60%) and 22 (74%) in the CSF, respectively, and 20 (67%) and 26 (87%) in the serum. Conclusion: An accurate and simple approach to the diagnosis of neurosyphilis remains elusive and the diagnosis continues to require a thorough assessment of the patient, including exposure to the risk, presence of compatible clinical signs and symptoms, and laboratory. While direct tests (such as microscopy or PCR) are useful in early infection, serological testing remains the mainstay of the diagnosis of neurosyphilis. Keywords: neurosyphilis, cerebrospinal fluid, treponema antibodies, protein MOJ Clinical & Medical Case Reports Case Report Open Access