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Published on: April 14, 2014
Ocular perineuritis secondary to neurosyphilis
1Midwestern University, Arizona College of Optometry, Glendale, Arizona 85038, USA. KellyMeehanOD@gmail.com
Summary
This case report details a rare instance of syphilitic ocular perineuritis in an HIV-positive individual. Early diagnosis and treatment of neurosyphilis are crucial for managing this optic nerve sheath inflammation.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Neurology
Background:
- Syphilis, caused by Treponema pallidum, is known as "the great masquerader" due to its diverse clinical presentations.
- Ocular manifestations of syphilis are varied, affecting both anterior and posterior eye segments.
- Neurosyphilis, a serious complication, can present with subtle or dramatic neurological and visual symptoms.
Observation:
- A 33-year-old HIV-positive male presented with blurred vision, floaters, headaches, nausea, weight loss, and a scalp rash.
- Fundoscopy revealed bilateral disc edema, suggesting optic nerve involvement.
- The patient's symptoms and signs were indicative of neurosyphilis with ocular complications.
Findings:
- The patient was diagnosed with syphilitic ocular perineuritis, an inflammation of the optic nerve sheath.
- This condition presented as bilateral disc edema without elevated intracranial pressure.
- Syphilitic ocular perineuritis is an uncommon but significant complication of neurosyphilis.
Implications:
- Prompt diagnosis of neurosyphilis and its ocular complications is vital.
- Syphilitic ocular perineuritis can be mistaken for papilledema or papillitis, highlighting the need for thorough syphilitic workup.
- Early treatment with penicillin can effectively manage neurosyphilis and prevent vision loss.
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