• Johanna Marie Birrell, Michael Lowe, Manoji Gunathilake, and Vicki Lynn Krause.
• Public Health Unit, Northern Territory Centre for Disease Control, Darwin, Northern Territory, Australia.
• Intern Med J. 2023 May 1; 53 (5): 738744738-744.

BackgroundThe Northern Territory (NT) of Australia is currently experiencing a syphilis epidemic. Neurosyphilis is commonly considered in the differential diagnosis for patients presenting with neurologic conditions such as dementia and stroke in the NT.AimsTo explore the local epidemiologic, diagnostic and treatment complexities of neurosyphilis in the NT and produce a guideline for clinical practice.MethodsA database search was undertaken and local and global neurosyphilis guidelines were analysed. A guideline was created based on findings of the critical review and consultation with local multidisciplinary experts.ResultsNeurosyphilis is frequently encountered in the NT but studies suggest it is often undertreated. Dementia is the most common clinical presentation locally. Establishing a diagnosis of neurosyphilis is complex and requires stepwise evaluation of clinical, laboratory and radiological findings.ConclusionsA clinical guideline and algorithm have been developed for the diagnosis and management of patients with neurosyphilis.© 2022 Royal Australasian College of Physicians.

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