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Rafael L. Jurado, MD
Decatur, Ga

Arch Intern Med. 1994;154(14):1644.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The letter by Haslett and Laverty describes a new clinical setting for the occurrence of the prozone phenomenon. The authors mention that the unexpected rapid decline of the original titer should have aroused some suspicion. We recently saw a very similar case. Our patient was human immunodeficiency virus positive, with a CD4 lymphocyte count of 0.02x10⁹/L and an original rapid plasma reagin titer of 1:2048 in March 1993. For his neurosyphilis (cerebrospinal VDRL was positive at a titer of 1:64) and coexistent bacterial endocarditis (group G Streptococcus), he received a 4-week treatment with penicillin, 3x10³ U intravenously every 4 hours. On follow-up 3 months later, his rapid plasma reagin titer was reported as nonreactive. On routine follow-up 6 months later, his rapid plasma reagin titer was again positive, with a titer of 1:2048. Unfortunately, the second specimen was not available for testing. The importance of the prozone . . . [Full Text PDF of this Article]

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