A Case of Ocular Syphilis in a 36-Year-Old HIV-Positive Male

Abstract

The incidence of syphilis in the United States has increased markedly over the last decade, particularly among men who have sex with men (MSM). Although uncommon, ocular involvement is a potentially devastating clinical manifestation of syphilis. Human immunodeficiency virus (HIV) infection appears to increase the risk of ocular syphilis. Because of the lack of pathognomonic features for ocular syphilis and its ability to occur in both immunocompetent and immunosuppressed individuals, prompt diagnosis requires a high index of suspicion. Ocular syphilis should therefore be considered in MSM and HIV-infected patients presenting with unexplained visual complaints. Herein, we present a case of ocular syphilis in a patient with newly diagnosed HIV.

Ocular Syphilis in a Kidney Transplant Recipient

“…Ocular syphilis should always prompt an analysis of the CSF to exclude associated neuro-syphilis 4 . The patient in the present report was immune compromised due to a kidney transplantation and the use of immune suppressive drugs, and lumbar puncture revealed lymphocytic pleocytosis with positive VRDL confirming the diagnosis of neuro-syphilis 20 .There are consistent recommendations to treat all the ocular syphilis cases as neuro-syphilis 2 , 3 , 12 , 13 , using high doses of intravenous penicillin 3 , 5 , 13 . The outcomes are usually good with quick and significant improvement, during the first 7 days, of the visual acuity, as observed in this case.…”