To the Editor: Drs. Johns1 and Berry2 and their colleagues (June 18 issue) have rendered a useful service in alerting the medical community to the potential for severe manifestations of syphilis and neurologic relapse after benzathine penicillin therapy in persons with human immunodeficiency virus (HIV) infection. The importance of considering neurosyphilis in the differential diagnosis of neurologic symptoms when evaluating persons with HIV infection, because of the strong epidemiologic association between these two infections,3 should be stressed. In Case 1 of Johns et al., symptoms of ocular4 and auditory5 neurosyphilitic involvement should have been evaluated with lumbar puncture and managed.
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