Atypical presentation of ocular syphilis in an individual with AIDS

Araújo, Paulo Sérgio Ramos de; Dias, Sandra; Gonzaga, Fabiana

doi:10.1590/0037-8682-0002-2014

Cited by 2 publications

(1 citation statement)

References 3 publications

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“…1 In some cases, its recognition may be delayed or may fail when patients are misdiagnosed because of the frequent misleading similarities of ocular syphilis with other ocular diseases. 2 Syphilitic chorioretinopathy can have different manifestations, such as acute/multifocal chorioretinitis, 3 acute posterior placoid chorioretinitis, 4 necrotizing retinitis, 5 and retinal vasculitis. 6 In the current paper, we report the case of a man who presented with acute syphilitic posterior placoid chorioretinopathy (ASPPC) revealing Human Immunodeficiency Virus (HIV) infection, initially diagnosed multiple evanescent white dot syndrome (MEWDS).…”

Section: Introductionmentioning

confidence: 99%

Acute syphilitic posterior placoid chorioretinopathy presenting as atypical multiple evanescent white dot syndrome

Azar

Wolff

Azam

et al. 2020

European Journal of Ophthalmology

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Background: This paper reports the case of a young man who presented with syphilis masquerading as multiple evanescent white dots syndrome (MEWDS), which turned out to be an acute syphilitic posterior placoid chorioretinopathy (ASPPC) during follow-up. Case presentation: A 59-year-old healthy male consulted for a three days’ history of visual impairment in both eyes. On multimodal imaging, he was diagnosed as MEWDS. Fundus fluorescein angiography (FFA) showed early peripheral bilateral granular hyperfluorescence that correlated with the yellow-white dots found on fundus exam. Indocyanine green angiography (ICGA) depicted hypofluorescent dots on late phase. Spectral-domain optical coherence tomography (SD-OCT) revealed numerous inner retinal highly reflective deposits in the outer nuclear layer and disruption of the ellipsoid zone. After initial improvement, he presented again for a sudden visual loss at 3 weeks. FFA, ICGA and SD-OCT demonstrated the same but more numerous and outer lesions suggesting an ASPPC. A full inflammatory work-up revealed highly positive titers of rapid plasma regain (RPR) and fluorescent treponemal antibody absorption (FTA-Abs), suggesting a syphilis infection. The ophthalmological manifestations dramatically improved after the patient was admitted for high-dose intravenous penicillin G 24 million per day for 2 weeks. Conclusion: This is the first case that reports an ocular syphilitic infection masquerading as MEWDS at presentation and that turns to be an ASPPC. Syphilis serology should be routinely done in every case of atypical MEWDS especially when unusually presented in a young healthy man, with bilateral involvement and a bad clinical evolution.

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Section: Introductionmentioning

confidence: 99%

Acute syphilitic posterior placoid chorioretinopathy presenting as atypical multiple evanescent white dot syndrome

Azar

Wolff

Azam

et al. 2020

European Journal of Ophthalmology

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Neurosyphilis Update: Atypical is the New Typical

Bhai

Lyons

2015

Curr Infect Dis Rep

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Syphilis has reemerged as an important cause of neurological disease, affecting any part of the neuraxis at any stage of infection. What was once a dwindling diagnosis is now redoubling, particularly in the HIV-positive and in men who have sex with men populations. In the era of antibiotics and HIV coinfection, neurosyphilis presentations are protean, making diagnosis notoriously challenging. Advanced disease may be irreversible, and so early detection and treatment are ideal. Herein, we review recent advances in understanding neurosyphilis.

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Atypical presentation of ocular syphilis in an individual with AIDS

Cited by 2 publications

References 3 publications

Acute syphilitic posterior placoid chorioretinopathy presenting as atypical multiple evanescent white dot syndrome

Acute syphilitic posterior placoid chorioretinopathy presenting as atypical multiple evanescent white dot syndrome

Neurosyphilis Update: Atypical is the New Typical

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