1/6. Syphilitic panuveitis and asymptomatic neurosyphilis: a marker of hiv infection.Co-existing human immunodeficiency virus (hiv) infection can alter the course and presentation of syphilis. Severe ocular manifestations and accelerated natural course of syphilis along with neurosyphilis may be associated with hiv infection. A 30-year-old man is described in whom syphilitic panuveitis and asymptomatic neurosyphilis served as a marker for hiv infection.- - - - - - - - - - ranking = 1keywords = panuveitis (Clic here for more details about this article) |
2/6. Syphilitic uveitis as the initial manifestation of hiv infection.Syphilis is an uncommon cause of uveitis in hiv-infected patients. We report a case of bilateral panuveitis and describe its characteristics as the initial manifestation of hiv infection. A 74-year-old heterosexual male complained of blurred vision and floaters in both eyes for 40 days. Slit lamp examination showed diffuse keratic precipitates and cells in the anterior chamber of both eyes. Fundus examination revealed multiple small white dots and scattered retinal hemorrhage over the mid-equatorial retina with marked vitritis. physical examination disclosed multiple erythematous papules over bilateral palms compatible with secondary syphilis. serologic tests--the venereal disease research laboratory (VDRL) test, fluorescent treponemal antibody absorption (FTA-ABS) test, and treponema pallidum hemagglutination (TPHA) test--were all positive. Aqueous fluid also showed positive FTA-ABS reaction. Under the impression of acquired secondary syphilis, enzyme-linked immunosorbent assay and Western blot test were performed and revealed concurrent hiv infection. After intravenous administration of penicillin-G, 18 million units daily for 2 weeks, the vitritis and retinochoroiditis improved. All patients with panuveitis of unknown cause should undergo VDRL and FTA-ABS screening. Subsequent testing for hiv antibody in leutic uveitis is also mandatory.- - - - - - - - - - ranking = 0.4keywords = panuveitis (Clic here for more details about this article) |
3/6. Ocular syphilis: the new epidemic.AIM: To present the clinical presentation, diagnosis, and management of syphilitic uveitis in the context of an epidemic of syphilis in the UK. METHOD: Retrospective clinical case series. RESULTS: Six new cases of syphilitic uveitis presented to the Manchester Uveitis Clinic in 2004, after a 15-fold increase in the incidence of syphilis in the UK, including 615 cases in Greater Manchester in the 5 years to 2004. Four cases had secondary syphilis, two had latent disease, two had no rash, and two were hiv positive. Ocular involvement included anterior or panuveitis, retinitis, retinal vasculitis, and papillitis. All resolved on treatment including intramuscular procaine penicillin g with oral probenecid. CONCLUSIONS: Syphilis is much more common recently and syphilitic uveitis should be considered in all patients with rash and/or headache, where there is retinitis and/or retinal vasculitis, or in any uveitis of uncertain origin. Treatment is that of neurosyphilis.- - - - - - - - - - ranking = 0.2keywords = panuveitis (Clic here for more details about this article) |
4/6. Bilateral giant retinal tear and retinal detachment in a young emmetropic man after Jarish-Herxheimer reaction in ocular syphilis.BACKGROUND: Giant retinal tears were previously described in patients affected by panuveitis. We report the case of a patient presenting giant retinal tears in both eyes affected by ocular syphilis. PATIENT AND METHOD: A 45-year-old patient presented a 5 days history of sudden bilateral drop of vision, two weeks after penicillin therapy for secondary syphilis. The best visual acuity was 0.5 RE and light perception LE. Biomicroscopy showed an intense vitritis associated with bilateral giant tear and retinal detachment. Both TPHA and VDRL were positive. Lumbar puncture showed lymphoplasmocytosis with intrathecal synthesis of IgM. RESULTS: Topical steroids treatment was applied and intravenous penicillin was given during 14 days. Pars plana vitrectomy with silicon oil tamponade was performed in association with endophotocoagulation in the left eye and cryocoagulation in the right eye. Vitreous PCR was negative. Evolution was successful with an attached retina. CONCLUSIONS: This represents the first reported case of giant retinal tear with retinal detachment in a patient presenting a syphilitic panuveitis.- - - - - - - - - - ranking = 0.4keywords = panuveitis (Clic here for more details about this article) |
5/6. An unexpected case of panuveitis.We report a case of sight-threatening secondary syphilis with hiv co-infection where atypical pattern of skin manifestations resulted in a delay in making the correct diagnosis. However, despite marked visual loss by the time correct diagnosis was made, the patient responded well, albeit slowly, to a course of intravenous benzyl penicillin.- - - - - - - - - - ranking = 0.8keywords = panuveitis (Clic here for more details about this article) |
6/6. A case of syphilitic uveitis.A 38-year-old man had anterior uveitis that failed to respond to increasingly aggressive therapy with topical and systemic corticosteroids and mydriatrics. His disease progressed to panuveitis and neuroretinitis and was finally cured with penicillin injections for acquired syphilis. He suffered secondary optic nerve atrophy. Because of the resurgence of the incidence of syphilis in the general population and the dire consequences for the patient in the absence of appropriate therapy, the ophthalmologist needs to consider the possibility of syphilis in his patients with uveitis. He should obtain serologic studies for syphilis.- - - - - - - - - - ranking = 0.2keywords = panuveitis (Clic here for more details about this article) |