Choreoretinitis as Initial Manifestation of Syphilis
Silva-Papi M., Mennel S., Meyer C. H.
Department of Ophthalmology, Philipps-University, Marburg
Purpose: Although the prevalence of syphilis is rare, it may occur as the initial manifestation of this disease.
Method: A 35-year-old man with acute decreased vision and photophobia received an opthalmoscopical and serological examination.
Results: Best corrected visual acuity was 20/ 600 in the effected eye. The anterior segment demonstrated a mild iridocyclitis. On fluorescein angiography there was a hyperemic optic nerve with an additional macular edema. Fundus examination disclosed numerous, white, chorioretinal infiltrates and signs of a periphlebitis in the peripheral retina. The laboratory testing presented a positive fluorescenc treponema pallidum antibody test. A regression of the uveitis could be followed after a systemic therapy with penicillin G.
Conclusions: Because ocular syphilis has no pathognomonic signs, its diagnosis is difficult without a positive serology. The opthalmologist has to consider syphilis as a possible diagnosis with increasing epidemiologic cases.
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