1/11. Differential diagnosis of optic neuritis in a patient with ankylosing spondylitis.The authors report a 38-year-old white man with ankylosing spondylitis (AS) who presented with recurrent ischaemic optic neuritis. The initial diagnosis was of multiple sclerosis, but further investigation showed serology and cerebrospinal fluid culture positive for syphilis. After treatment for tertiary syphilis with penicillin, there was complete remission of the ocular symptoms. This case illustrates the differential diagnosis of optic neuritis in AS and supports the relevance of investigating infectious diseases in the management of ischaemic optic neuritis.- - - - - - - - - - ranking = 1keywords = neuritis (Clic here for more details about this article) |
2/11. The histopathology of syphilis of the oral mucosa.BACKGROUND: Reported cases of syphilis in the united states, europe and elsewhere are increasing in number. Clinical manifestations are protean, and oral biopsies may be taken where the diagnosis is unsuspected, but data on the histopathology of oral mucosal syphilis are sparse. methods: The histopathology of five oral lesions in patients with serologically proven syphilis was reviewed. RESULTS: There were two cases of primary syphilis, one secondary and two tertiary. Epithelial hyperplasia was present in three cases, and was pseudocarcinomatous in one case of primary syphilis, and psoriasiform in the secondary lesion, where heaped-up epithelium surrounded a defined crater covered by flatter epithelium. plasma cell (primary and secondary disease) and granulomatous (tertiary) infiltrates were prominent. Other features observed were endarteritis (5/5), plasma cell neuritis (3/5) and spirochetes (4/5). CONCLUSIONS: Although no single microscopic feature is specific, a diagnosis of syphilis should be considered where there is unusual epithelial hyperplasia, granulomatous or plasma cell-predominant chronic inflammation, endarteritis and neuritis.- - - - - - - - - - ranking = 0.28571428571429keywords = neuritis (Clic here for more details about this article) |
3/11. The ocular manifestations of syphilis in the human immunodeficiency virus type 1-infected host.Nine patients with active ocular or optic nerve involvement by syphilis who also had concurrent human immunodeficiency virus type-1 (hiv-1) infection are described. The ocular manifestations of syphilis led to the discovery of hiv-1 seropositivity in four of nine cases. Fifteen eyes were affected. Ocular manifestations were: iridocyclitis in three eyes, vitreitis in one eye, retinitis or neuroretinitis in five eyes, papillitis in two eyes, optic perineuritis in two eyes, and retrobulbar optic neuritis in two eyes. Three patients diagnosed with acquired immune deficiency syndrome (AIDS) had the worst initial visual acuities. Six of nine patients had evidence of concomitant central nervous syndrome (CNS) involvement with syphilis. Benzathine penicillin was administered intramuscularly to three patients. All three had relapses. Seven of nine patients treated intravenously with high-dose penicillin had dramatic responses to therapy with improvement in vision and serologies and no evidence of relapse. Regimens accepted for the treatment of neurosyphilis appear to be adequate for the treatment of ocular syphilis in hiv-1-infected patients though further long-term follow-up will be required.- - - - - - - - - - ranking = 0.28571428571429keywords = neuritis (Clic here for more details about this article) |
4/11. Secondary syphilis presenting with optic perineuritis and uveitis.We describe a 40 year-old man with optic perineuritis due to secondary syphilis. This condition which is due to inflammation of the optic nerve sheath is often mistaken for papilloedema or papillitis. We discuss its diagnosis and stress the importance of recognising it because it is easily treated by a course of Penicillin.- - - - - - - - - - ranking = 0.71428571428571keywords = neuritis (Clic here for more details about this article) |
5/11. Choroidal neovascular membrane and other chorioretinal complications of acquired syphilis.We reviewed ten patients who had posterior segment complications of acquired syphilis. Five of these patients had a neovascular membrane of the choroid associated with secondary or tertiary syphilis. Vision was stabilized after laser photocoagulation in one patient who had a choroidal neovascular membrane. Five additional patients had ocular manifestations including uveitis, optic neuritis, neuroretinitis, chorioretinitis, retinal hemorrhages, arterial and venous occlusion, vasculitis, and retinitis. Treatment of chorioretinal complications of syphilis with intravenous penicillin, if initiated early in the course of the disease, may result in excellent visual recovery.- - - - - - - - - - ranking = 0.14285714285714keywords = neuritis (Clic here for more details about this article) |
6/11. Acute syphilitic blindness in AIDS.To our knowledge, bilateral syphilitic optic neuritis has not been reported in conjunction with AIDS. We document a case of a bisexual man with AIDS whose vision deteriorated overnight from 20/20 in both eyes to total bilateral blindness as a result of syphilitic retrobulbar neuritis. The implications and management of leutic disease in immunocompromised individuals are discussed.- - - - - - - - - - ranking = 0.28571428571429keywords = neuritis (Clic here for more details about this article) |
7/11. Optic perineuritis with secondary syphilis.Optic perineuritis is characterized by swollen optic discs in the absence of raised intracranial pressure and visual dysfunction. A patient with secondary syphilis who presented with these features is described. The need to recognize the spectrum of ocular and optic nerve involvement in secondary syphilis is emphasized.- - - - - - - - - - ranking = 0.71428571428571keywords = neuritis (Clic here for more details about this article) |
8/11. Ocular syphilis in patients with human immunodeficiency virus infection.We diagnosed ocular syphilis in three homosexual men infected with human immunodeficiency virus (HIV). Ocular inflammation included uveitis, optic neuritis, and retinitis. Dermatologic and central nervous system manifestations of secondary syphilis were also present. The history of homosexuality was difficult to obtain. Concomitant infection with HIV may alter the course of syphilis, obscure the diagnosis, and impair the response to therapy.- - - - - - - - - - ranking = 0.14285714285714keywords = neuritis (Clic here for more details about this article) |
9/11. Syphilitic optic perineuritis.We examined a patient who had syphilitic perioptic neuritis, a rarely diagnosed inflammation of the sheaths of the optic nerves that may be confused with papilledema caused by brain tumor or pseudotumor cerebri. The visual acuity was typically normal, and the only visual-field abnormality was enlargement of the blind spots. After we excluded an intracranial mass lesion, the diagnosis was confirmed by cerebrospinal fluid serologic findings positive for syphilis and normal intracranial pressure. Anti-inflammatory and antisyphilitic therapy resolved all the symptoms in our patient.- - - - - - - - - - ranking = 0.71428571428571keywords = neuritis (Clic here for more details about this article) |
10/11. optic neuritis--etiology?A 44-year-old otherwise healthy woman was referred to washington University with previous diagnoses of para planitis and retrobulbar neuritis, and with a current complaint of markedly decreased vision (light perception only) in the right eye. Among the findings at the time of this evaluation were posterior uveitis and evidence of optic neuropathy and of a disordered immune system. The patient responded to pulsed high-dose corticosteroid therapy. A subsequent similar episode in the left eye also was resolved with such treatment. Dr. Burde describes the case in detail and asks Drs. Keltner, Gittinger and Miller to offer diagnoses. Their answers vary considerably.- - - - - - - - - - ranking = 0.71428571428571keywords = neuritis (Clic here for more details about this article) |
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