[Primary diagnosis of syphilis by the ophthalmologist].
BACKGROUND
Throughout the developed world the reported incidence of sexually transmitted diseases is rising with previously unreported cases at rates of 40 - 70 %. According to German sources, recent epidemiological data show a considerable increase of syphilis especially among homosexual men in larger cities.


METHODS
We report on 4 patients (age 38 - 54) who were referred to our outpatient department because of vision loss of unknown origin. All were subsequently tested positive for syphilis. None of the patients (3 men, 1 woman) belonged to a risk group, only one described systemic symptoms (urethritis and arthritis). The ocular manifestations of syphilis were broad: granulomatous and non-granulomatous anterior uveitis, papillitis, and chorioretinitis. Two patients also tested positive for HIV. After systemic antibiotic therapy, the ocular diseases stabilized.


CONCLUSIONS
Diagnosis and therapy of syphilis is cost-effective. The rise of syphilis especially in urban areas necessitates a high level of suspicion dealing with patients with intraocular inflammation of unknown origin. Lues serology should be incorporated into routine lab diagnostics to aid in the detection of such cases.
Porstmann
Agnes Ute
AU
Universitätsaugenklinik Charité, Fakultät der Humboldt-Universität Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin.
Marcus
Ulrich
U
Pleyer
Uwe
U
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission; D000328:Adult; D002825:Chorioretinitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005128:Eye Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D005451:Fluorescein Angiography; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D010211:Papilledema / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D010348:Patient Care Team; D010406:Penicillins / Q000627:therapeutic use; D013587:Syphilis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission; D013588:Syphilis Serodiagnosis; D014505:Urban Population / Q000706:statistics & numerical data; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
D010406:Penicillins