P2.134 Ophthalmic and Otolaryngological Manifestations of Syphilis in Patients with HIV

Abstract

Conclusions PCB is a benign condition, with characteristic clinical and histopathological features. Although various treatment modalities have been used, circumcision remains the treatment of choice. PCB is an expression of dysfunctional foreskin, moreover the curative effect of circumcision in 100% of our patients suggests that it is a nonspecific reactive balanitis caused by a disturbed "preputial-ecology. Background Recently noteworthy aspect of the problem is associated with an increase in cases of syphilis as part of mixed infection including HIV. Mixed infection syphilis and HIV alters the clinical picture and prognosis of both diseases. Methods 316 patients with early forms of syphilis were treated in city hospital in St. Petersburg in 2006-2010. The study group included 153 patients with syphilis + HIV (10 -primary syphilis, 117 -secondary syphilis, 26 -early neurosyphilis). Control group -163 patients with syphilis (14 -primary syphilis, 115 -secondary syphilis, 34 -early neurosyphilis). Ophthalmic and otolaryngological manifestations of syphilis were estimated. Results Ophthalmic and otolaryngological manifestations of syphilis were diagnosed in 18 (11.8%) patients of study group and 4 (2.5%) -control group (p < 0.05). 12 and 2 patients with secondary syphilis, 6 and 2 patients with early neurosyphilis of study and control group respectively. OPhthalmic andIn none of the groups ophthalmic and otolaryngological manifestations in patients with primary syphilis were not determined. Specific papillitis (5 (3.3%)) and specific panuveit (5 (3.3%) as well as specific laryngeal neuropathy (1 (0.6%)) and specific bilateral hypoacusis (1 (0.6%)) were identified only in study group. Specific anterior uveitis was detected in both groups (1 and 2 patients), specific angina (3 and 1 patients) and specific laryngitis (monochorditis) (2 and 1 patients) of study and control group respectively.Among 18 patients of study group with ophthalmic and otolaryngological manifestations were 12 cases of secondary syphilis and 6 -early neurosyphilis. 1 patient showed simultaneous ophthalmic, otolaryngological disorders and diffuse neurological symptoms. Conclusion Clinical manifestations of syphilis were more varied in patients with HIV. Ophthalmic and otolaryngological manifestations of syphilis were more common in patients with mixed infection syphilis + HIV, which may indicate a more severe course of syphilis in these patients.

Pénicilline G benzathine pour la prise en charge de la syphilis précoce chez les personnes co-infectées par le VIH : un examen systématique

“…En outre, les déclarations de cas et les études de cas révèlent que la co-infection par le VIH peut donner lieu à des manifestations atypiques ou plus graves de la syphilis. Les personnes séropositives sont plus à risque de présenter plusieurs ulcères plus gros, ainsi que des infections primaires et secondaires concomitantes; les anomalies du liquide céphalorachidien, et les manifestations oculaires et ophtalmologiques sont plus courantes (9)(10)(11)(12)(13). La syphilis intercurrente peut également augmenter temporairement la En outre, le traitement optimal des personnes séropositives co-infectées par la syphilis précoce est controversé depuis le signalement précoce d'échecs de traitement à la fin des années 1980 qui a suivi la publication des schémas thérapeutiques standards recommandés (16).…”

Benzathine penicillin G for the management of early syphilis among HIV co-infected persons: A systematic review

“…In addition, case reports and case series suggest that co-infection with HIV can result in atypical or more severe manifestations of syphilis. HIV-positive persons are more likely to present with multiple, larger ulcers, primary and secondary infections can overlap and cerebrospinal fluid (CSF) abnormalities, ocular and ophthalmologic manifestations are more common (9)(10)(11)(12)(13). Intercurrent syphilis may also temporarily increase HIV viral load and reduce CD4 lymphocyte count (14,15).…”