[Uveitis in acquired syphilis]

Syphilis is a well-established cause of uveal disease and is thought to be responsible for several distinct types of intraocular inflammation. Four cases of acquired syphilitic uveitis are reported. The diagnosis was essentially based on the clinical picture, the elimination of other possible causes, the results of reliable blood immunologic tests eg, the TPHA, FTA and Nelson tests, and the rapid response to penicillin therapy. Evaluation of anti-Treponema pallidum antibodies in the aqueous humor does not contribute to the diagnosis of syphilitic uveitis. Two cases needed large amounts of penicillin (total dosage, 440 million units). Oral steroids were used to control the associated inflammatory reaction and to prevent a Herxheimer reaction. All the patients responded well to therapy.