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Simultaneous ocular and osseous syphilis: a case report.

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  • 1Department of Ophthalmology and Otorhinolaryngology, Universidade Estadual de Campinas, Campinas, SP, Brazil.

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Summary

Syphilis, a reemerging disease, can mimic other conditions. This case highlights secondary syphilis affecting the eyes and bones, successfully treated with penicillin.

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Area of Science:

  • Ophthalmology, Neurology, Infectious Diseases

Background:

  • Syphilis is a reemerging infectious disease known for its diverse clinical presentations, often termed 'the great imitator'.
  • Secondary syphilis represents a stage of high bacteremia and transmissibility, primarily manifesting with mucocutaneous lesions but capable of multi-organ involvement.

Observation:

  • A young woman presented with bilateral acute syphilitic posterior placoid chorioretinopathy and skull periostitis.
  • Magnetic resonance imaging revealed pachymeningeal enhancement, interpreted as contiguous spread from the periostitis rather than meningitis due to normal cerebrospinal fluid analysis.

Findings:

  • The patient's ocular and bone manifestations were attributed to secondary syphilis.
  • Intravenous crystalline penicillin therapy led to complete resolution of clinical symptoms and imaging abnormalities.

Implications:

  • This case underscores the importance of high clinical suspicion for syphilis in patients with atypical multi-organ involvement.
  • A pragmatic diagnostic approach is crucial for recognizing and managing syphilis, which can affect various systems including the eyes and bones.