A 29-year-old transgender woman presents with a new severe headache and diffuse rash on her chest and back. Laboratory studies showed she had a positive treponemal enzyme immunoassay (EIA) and a positive serum Rapid Plasma Reagin (RPR) with a titer of 1:128. Initial lumbar puncture cerebrospinal fluid (CSF) studies showed a white blood cell count of 36 cells/mm3 (84% lymphocytes), protein of 78 mg/dL, and positive Venereal Disease Research Laboratory (VDRL) titer of 1:64. An HIV-1/2 antigen-antibody test was negative. She is diagnosed with secondary syphilis and neurosyphilis and receives appropriate treatment. Six months later her neurologic symptoms have resolved, and a repeat serum RPR titer is 1:8.
Which one of the following should be recommended regarding a follow-up lumbar puncture with CSF analysis?
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Question Last Updated
November 5th, 2021
November 5th, 2021
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