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Optic neuritis secondary to syphilis.

I Téllez Guzmán1, M C Atilano Anzaldo1, K P Delgado Moreno2

  • 1Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional Valentín Gómez Farias, Zapopan, Jalisco, Mexico.

Archivos De La Sociedad Espanola De Oftalmologia
|March 23, 2024
PubMed
Summary
This summary is machine-generated.

Syphilis can cause optic neuritis, a rare but serious eye condition. This case highlights the importance of considering syphilis in patients with vision loss, especially those with HIV.

Keywords:
Análisis líquido cefalorraquídeoCerebrospinal fluid analysisNeuritis ópticaNeurosyphilisNeurosífilisOptic neuritisSyphilisSífilis

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Neurology

Background:

  • Syphilis, a complex infectious disease, can present with diverse neurological and ocular manifestations.
  • Neurosyphilis, encompassing central nervous system involvement, requires high clinical suspicion due to its varied presentations.
  • Optic neuritis is an uncommon but significant ocular complication of syphilis.

Observation:

  • A 62-year-old male with recent HIV diagnosis presented with decreased vision and myodesopsias in the right eye.
  • Ophthalmic examination revealed a hyperemic optic nerve with peripapillary hemorrhages and retinal pigment epithelium hyperplasia.
  • Positive syphilis serology was noted, with decreasing nontreponemal test levels after ceftriaxone treatment.

Findings:

  • The case illustrates optic neuritis as a rare manifestation of syphilis.
  • The patient's presentation underscores the potential for syphilis to mimic other conditions, earning it the moniker 'great imitator'.
  • Successful treatment with ceftriaxone led to a decrease in syphilis markers.

Implications:

  • Optic neuritis should be considered in the differential diagnosis of vision loss, particularly in patients with risk factors for syphilis or HIV.
  • Early diagnosis and treatment of neurosyphilis are crucial to prevent irreversible vision loss and neurological damage.
  • This case emphasizes the importance of comprehensive evaluation for syphilis in patients presenting with unexplained ocular inflammatory conditions.