Manifestations and treatment of ocular syphilis during an epidemic in France.
OBJECTIVE
To review cases of ocular syphilis presenting to a tertiary uveitis clinic during a syphilis epidemic in France between January 2001 and January 2004.


METHODS
Retrospective chart and patient database review.


RESULTS
Ten patients who presented with symptoms and signs of uveitis tested positive for active syphilis. Some of the patients also presented with a rash or headache. Human immunodeficiency virus (HIV) antibody testing was positive in eight of the 10 patients, with CD4 cell counts >200 cells/mm3 in seven of the patients. Ocular inflammation resolved and visual acuity improved in all patients after treatment.


CONCLUSIONS
A diagnosis of ocular syphilis should be considered in any patient with visual loss associated with a rash or headache, irrespective of the patient's CD4 cell count. Ocular syphilis in HIV-positive patients should be treated as neurosyphilis, whereas ocular syphilis in non-HIV patients can be treated as secondary syphilis.
Department of Ophthalmology, Cochin Hospital, Paris V University, Paris, France. c.parc@hopitalfoch.org
Christine E
CE
Parc
Sadri
S
Chahed
Sanjay V
SV
Patel
Dominique
D
Salmon-Ceron
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004196:Disease Outbreaks; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009494:Neurosyphilis / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D012189:Retrospective Studies; D013588:Syphilis Serodiagnosis; D014605:Uveitis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D014792:Visual Acuity
D000900:Anti-Bacterial Agents