@article{oai:jichi-ir.repo.nii.ac.jp:00000530, author = {Minato, Saori and yamashita, Takeshi and Yoshida, Katsuyuki and Kawamura, Ai and Watanabe, Tamami and Ishii, Akira and Fukuchi, Takahiko and Sugawara, Hitoshi and Kawase, Masaaki and Demitsu, Toshio}, journal = {自治医科大学紀要, Jichi Medical University Journal}, month = {Mar}, note = {The“ Stop! Syphilis Project” was started in Japan in 2018. A 29-year-old woman was admitted with fever, acute onset of posterior cervical pain, urodynia, and positive signs of meningeal irritation. Three months before admission, her heterosexual partner had been diagnosed with primary symptomatic syphilis with induration, but her initial serological screening tests for syphilis [rapid plasma reagin (RPR) test and Treponema pallidum hemagglutination (TPHA) test] were negative. She presented with a painless genital lesion at 2 months before the current hospitalization and with skin rashes at 1 month before hospitalization; however, these were not recognized as symptomatic for syphilis. Additionally, urodynia appeared at 2 weeks before admission; the patient underwent serological rescreening for syphilis, which tested positive (RPR: 128-fold, TPHA: 640.0 titer unit), and posterior cervical pain appeared at 10 days before hospitalization. After emergent hospitalization, she was diagnosed with syphilitic meningitis without human immunodeficiency virus infection. Antimicrobial treatment with penicillin G was continued for 2 weeks, after which the fever, posterior cervical pain, urodynia, and rash subsided, and the patient was discharged on hospital day 16. On day 187 after starting treatment, RPR was 8-fold and TPHA was 262.4 titer unit. This case report highlights the fact that for the timely detection and appropriate treatment of syphilis,primary care physicians should recommend a repeated RPR test with incubation period taken into account,even in the absence of symptoms and even if initial screening results are negative.}, pages = {29--34}, title = {Syphilitic Meningitis in a Human Immunodeficiency Virus-Negative Woman}, volume = {41}, year = {2019} }