title: Adult-onset syphilitic stromal keratitis.
abstract: OBJECTIVE
  To characterize the clinical features and therapeutic outcome of stromal keratitis associated with syphilis in adults.
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  We examined the clinical and laboratory records at a single center of individuals with active stromal keratitis who had serological evidence of syphilis by a treponemal specific test.
  
  
  RESULTS
  Five patients, 36 to 81 years of age, developed stromal keratitis during late syphilis. One patient with developmental signs of congenital syphilis had bilateral stromal keratitis. The others were otherwise healthy when they presented with unilateral, nonulcerative, infiltrative keratitis with stromal edema of the peripheral or paracentral cornea and mild to moderate corneal vascularization. All had an appropriate response to topical corticosteroid therapy, and two recovered good vision. Stromal keratitis recurred in two patients months to years later.
  
  
  CONCLUSIONS
  Nonulcerative stromal keratitis presents in adults with syphilis as marginal, central, or multifocal stromal inflammation with neovascularization that responds to corticosteroid therapy but occasionally recurs.
authors.affiliation: Sid W. Richardson Ocular Microbiology Laboratory, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas 77030, USA. kirkw@bcm.tmc.edu
authors.forename: Kirk R
authors.initials: KR
authors.lastname: Wilhelmus
authors.forename: Dan B
authors.initials: DB
authors.lastname: Jones
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003319:Corneal Stroma / Q000187:drug effects / Q000382:microbiology* / Q000473:pathology; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000031:analogs & derivatives / Q000627:therapeutic use; D012008:Recurrence; D013587:Syphilis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D013588:Syphilis Serodiagnosis
chemical_list: D005938:Glucocorticoids; C009935:prednisolone acetate; D011239:Prednisolone