Triple trouble: A case of retinochoroiditis in a patient with syphilis, tuberculosis, and human immunodeficiency virus infection

Abstract

A 31-year-old male patient presented with sudden onset loss of vision in the left eye. Ocular examination revealed significant vitritis with chorioretinitis lesion in the posterior pole. Subsequent investigations revealed positive human immunodeficiency virus (HIV) and syphilis serology; chest imaging revealed active pulmonary tuberculosis. Polymerase chain reaction from aqueous aspirate was positive for Mycobacterium tuberculosis . There was complete resolution of the lesions following antisyphilitic medications, antitubercular therapy along with highly active antiretroviral therapy. Syphilis and tuberculosis coinfection in a previously unknown HIV patient is rare but can occur. It is worthwhile to look for multiple coinfections in HIV patients.

A triple case series of uveitis caused by HIV, syphilis and tuberculosis coinfection

“…Tuberculosis (TB) and syphilis are well known diseases in patients with HIV [1,2]. The prevalence of TB in South Africa in 2018 was 737 per 100 000 [3].…”

“…A triple case series of uveitis caused by HIV, syphilis and tuberculosis coinfection Tuberculosis (TB) and syphilis are well known diseases in patients with HIV [1,2]. The prevalence of TB in South Africa in 2018 was 737 per 100 000 [3].…”

“…Ocular manifestations of each disease have been well documented, but, to our knowledge, only one case with ocular TB (OTB) and syphilis coinfection in an HIV-positive patient has been reported. 2,2 This case series describes three such patients treated at Tygerberg Hospital, Cape Town, South Africa.…”

“…GlycA is associated with neuropsychological impairment in men with HIV Neuropsychological impairment (NPI) remains prevalent among people with HIV (PWH) despite combination antiretroviral therapy (ART) [1,2]. NPI is associated with reduced quality of life [3], worse everyday functioning [4], and increased mortality risk [5,6].…”

Commentry: Ocular coinfections in human immunodeficiency virus infection—What is so different?

“…Ocular syphilis remains one of the common cause of bacterial infection in HIV-positive patients. [ 5 ] Syphilis infection in HIV-infected men has been associated with a significant increase in the HIV viral load and a significant decrease in the CD4 cell count. Kate Buchacz et al .…”