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Bilateral hypopyon in syphilitic uveitis.

Monica P Gonzalez Collazo1, Nicole P Rebollo Rodriguez1, Marely Santiago-Vazquez2

  • 1University of Puerto Rico, Medical Sciences Campus, School of Medicine, Department of Ophthalmology, San Juan, PR, USA.

American Journal of Ophthalmology Case Reports
|January 13, 2021
PubMed
Summary
This summary is machine-generated.

Syphilitic uveitis can rarely present as bilateral hypopyon. This case highlights the importance of considering syphilis in the differential diagnosis for patients with bilateral hypopyon.

Keywords:
HypopyonInfectious uveitisSyphilisUveitisVitrectomy

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Immunology

Background:

  • Syphilitic uveitis is an ocular manifestation of syphilis, a sexually transmitted infection.
  • Uveitis, inflammation of the uvea, can present with various clinical signs, including hypopyon (pus in the anterior chamber).

Observation:

  • A 38-year-old male presented with acute bilateral visual loss, conjunctival hyperemia, and photophobia.
  • Physical examination revealed widespread mucocutaneous lesions, lymphadenopathy, and genital findings consistent with secondary syphilis.
  • Ophthalmologic examination showed bilateral hypopyon and vitritis, with diagnostic vitrectomy revealing a mixed inflammatory infiltrate.

Findings:

  • Laboratory tests confirmed syphilis with positive RPR, FTA-Abs, and VDRL in CSF.
  • The patient was also diagnosed with HIV co-infection.
  • Treatment with intravenous penicillin G and topical corticosteroids led to complete resolution of the uveitis.

Implications:

  • Bilateral hypopyon is an atypical but possible presentation of syphilitic uveitis.
  • Ophthalmologists should include syphilis in the differential diagnosis for patients with bilateral hypopyon, especially those with suggestive systemic signs.
  • Early diagnosis and treatment of syphilitic uveitis are crucial to prevent vision loss.