A case of secondary syphilis presenting as optic neuritis.
Neurosyphilis is still a significant medical problem in developing countries and syphilitic ocular manifestations are often not diagnosed due to the lack of typical characteristics. We describe the case of a 59-year-old homosexual man with a 1-month history of decreased vision acuity in his left eye who was diagnosed with neurosyphilis and received treatment with intravenous penicillin G (16 million units in divided daily doses), with great improvement of visual acuity and CSF examination findings. The interest of this case is not only represented by the unusually early ocular involvement, but also by the rapid evolution of the disease into the secondary stage in a man who had had one at-risk homosexual relationship only 3 months before the onset symptoms. We also support the view that the presence of ocular involvement in syphilitic patients is suggestive of involvement of the CNS and should be considered synonymous with neurosyphilis.
Bandettini di Poggio
Monica
M
Department of Neurology, Ophthalmology and Genetics, San Martino Hospital, University of Genoa, Via De Toni 5, 16132, Genoa, Italy. monicabandettini@yahoo.it
Primavera
Alberto
A
Capello
Elisabetta
E
Bandini
Fabio
F
Mazzarello
Giovanni
G
Viscoli
Claudio
C
Schenone
Angelo
A
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D018450:Disease Progression; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009494:Neurosyphilis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D009898:Optic Disk / Q000473:pathology; D009902:Optic Neuritis / Q000175:diagnosis* / Q000473:pathology; D010400:Penicillin G / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D010400:Penicillin G