A 48-year-old woman with red eyes and a rash

Mikita, Cecilia P.; Truesdell, Alex G.; Katial, Rohit

doi:10.1016/s1081-1206(10)61258-6

Cited by 4 publications

(3 citation statements)

References 10 publications

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“… 8 , 9 Initial presentation to the ophthalmologist may include nonspecific symptoms of headache, eye pain, rash, with an elevated erythrocyte sedimentation rate, and no subsequent response to prednisolone. 10 Despite its low incidence, ocular syphilis may represent the only systemic manifestation of syphilitic disease, with failure of prompt diagnosis and treatment leading to possible further transmission of a highly contagious infection, poor visual outcome, and severe neurological compromise with progression to neurosyphilis. 8 …”

Section: Discussionmentioning

confidence: 99%

Three cases of ocular syphilis and the resurgence of the disease in Queensland

Sara¹,

McAllister²

2016

IMCRJ

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The past few years has seen a resurgence of syphilis. It is predominantly associated within men who have sex with men and also within heterosexual Indigenous Australians. Possessing the ability to mimic a variety of ocular diseases, it typically manifests as uveitis, although it can affect any structure within the eye. Thus, a high degree of clinical suspicion by ophthalmologists is required to prevent disease progression and ocular morbidity. Patients require prolonged antibiotic treatment with intravenous benzylpenicillin and outpatient monitoring to successfully resolve the infection. We describe a case series of ocular syphilis presentations in Queensland, Australia.

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Section: Discussionmentioning

confidence: 99%

Three cases of ocular syphilis and the resurgence of the disease in Queensland

Sara¹,

McAllister²

2016

IMCRJ

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“…Ocular syphilis is a slow painless decrease in vision and there are no signs that are pathognomonic. 12 , 13 A case report suggests a triad of headache, red eye or eye pain, and elevated erythrocyte sedimentation rate should prompt clinical suspicion for ocular syphilis. 12 The AR pupil is highly specific for neurosyphilis, but as in this case it was not present.…”

Section: Discussionmentioning

confidence: 99%

Don’t Forget What You Can’t See: A Case of Ocular Syphilis

Lee

Sumsion

et al. 2016

WestJEM

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This case describes an emergency department (ED) presentation of ocular syphilis in a human immunodeficiency virus (HIV) infected patient. This is an unusual presentation of syphilis and one that emergency physicians should be aware of. The prevalence of syphilis has reached epidemic proportions since 2001 with occurrences primarily among men who have sex with men (MSM). This is a case of a 24-year-old male who presented to our ED with bilateral painless vision loss. The patient’s history and ED workup were notable for MSM, positive rapid plasmin reagin (RPR) and HIV tests and fundus exam consistent with ocular syphilis, specifically uveitis. Ocular manifestations of syphilis can present at any stage of syphilis. The 2010 Centers for Disease Control and Prevention guidelines now recommend that ocular syphilis be treated as neurosyphilis regardless of the lumbar puncture results. There is a paucity of emergency medicine literature on ocular syphilis. For emergency physicians it is important to be aware of iritis, uveitis, or chorioretinitis as ocular manifestations of neurosyphilis especially in this high-risk population and to obtain RPR and HIV tests in the ED to facilitate early diagnosis, and treatment and to prevent irreversible vision loss.

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“…Perhaps the most generally informative recent paper on syphilis is a case report [11] describing a 48-year-old woman with headache, eye pain, and a rash, with an erythrocyte sedimentation rate (ESR) of 120, unresponsive to 4 weeks' treatment with prednisone and additional treatment for migraine headaches and allergic conjunctivitis. She was eventually found to have syphilis and treated appropriately, with excellent response.…”

Section: Syphilitic Ocular Manifestationsmentioning

confidence: 99%