All patients on anti-TNF therapy had positive serological tests; however, immunosuppression is a risk factor for the accelerated course of the disease, and potentially for neurosyphilis (Supplementary Table 1).3, 4, 5, 6, 7, 8 The confirmation of neurosyphilis, ocular syphilis or otosyphilis requires the intravenous use of crystalline penicillin G 18 to 24 million units per day, or alternatively ceftriaxone 1 g to 2 g daily (intravenously or intramuscularly) for ten to 14 days.9 This evidence concerns the gene TNF and neurosyphilis.