Abstract
Neurosyphilis is still a significant medical problem in developing countries and syphilitic ocular manifestations are often not diagnosed due to the lack of typical characteristics. We describe the case of a 59-year-old homosexual man with a 1-month history of decreased vision acuity in his left eye who was diagnosed with neurosyphilis and received treatment with intravenous penicillin G (16 million units in divided daily doses), with great improvement of visual acuity and CSF examination findings. The interest of this case is not only represented by the unusually early ocular involvement, but also by the rapid evolution of the disease into the secondary stage in a man who had had one at-risk homosexual relationship only 3 months before the onset symptoms. We also support the view that the presence of ocular involvement in syphilitic patients is suggestive of involvement of the CNS and should be considered synonymous with neurosyphilis.
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References
Parc CE, Chahed S (2007) Manifestation and treatment of ocular syphilis during an epidemic in France. Sex Transm Dis 34(8):553–556
Maves RC, Cachay ER (2008) Secondary syphilis with ocular manifestation in older adults. Clin Inf Dis 46:e142–e145
Centers for Disease Control and Prevention (2006) Sexually transmitted disease survelliance. US Department of Health and Human Services, Atlanta
Public Health Agency of Canada (2004) Canadian sexually transmitted infectious surveillance report. CCDR, 33S1:1–69
Lukehart SA, Hook EW (1988) Invasion of the central nervous system by Treponema pallidum: implications for diagnosis and treatment. Ann Intern Med 109:855–862
Chao JR, Khurana RN (2006) Syphilis: re-emergence of an old adversary. Ophthalmology 113(11):2074–2079
Kunkel J, Schurmann D (2008) Ocular syphilis-indicator of previously unknown HIV-infection. J Infect xx:1–5
Lynn WA, Lightman S (2004) Syphlis and HIV: a dangerous combination. Lancet Inf Dis 4:456–466
Gurses C, Bilgic B (2007) Clinical and magnetic resonance imaging findings of HIV-negative patients with neurosyphilis. J Neurol 254(3):368–374
Centers for Disease Control, Prevention (1998) 1998 guidelines for treatment of sexually transmitted diseases. M M Weekly Rep 47:28–49
Singh AE, Romanowski B (1999) Syphilis: review with emphasis on clinical epidemiologic, and some biologic features. Clin Microbiol Rev 12:187–209
Gt Smith, Goldmeier D (2006) Neurosyphilis with optic neuritis: an update. Postgrad Med J 82(963):36–39
Murat summer M, Yuksel D (2000) Neurosyphilis presenting with optic neuropathy. Ann Ophthalmol 32(1):30–32
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Bandettini di Poggio, M., Primavera, A., Capello, E. et al. A case of secondary syphilis presenting as optic neuritis. Neurol Sci 31, 365–367 (2010). https://doi.org/10.1007/s10072-010-0222-8
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DOI: https://doi.org/10.1007/s10072-010-0222-8