title: Unilateral swollen optic disc: do not forget neurosyphilis.
abstract: A 51-year-old man presented with a 3 month history of progressive right visual loss. On examination, the only abnormal findings were a right visual acuity of 4/10 and a swollen right optic disc. The patient had previously undergone MRI that had been reported as being normal and a trial of corticosteroids under the care of the referring ophthalmologist. An extensive battery of blood tests was normal apart from a rapid plasmatic reagin titre of 1:64. ELISA revealed elevated levels of total and immunoglobulin M antibodies against Treponema pallidum. Cerebrospinal fluid analysis revealed a mild leucocytosis and mildly elevated protein content. The patient was treated with a 5 week course of penicillin. Three months after starting treatment, his right visual acuity had improved to 8/10 and his right optic disc swelling had resolved.
authors.affiliation: Department of Internal Medicine 1, Centro Hospitalar Tondela-Viseu, Viseu, Portugal. leneaporto@gmail.com
authors.forename: Lénea
authors.initials: L
authors.lastname: Porto
authors.forename: Joana
authors.initials: J
authors.lastname: Capelo
authors.forename: Adelino
authors.initials: A
authors.lastname: Carragoso
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D009494:Neurosyphilis / Q000150:complications / Q000175:diagnosis*; D010211:Papilledema / Q000209:etiology / Q000473:pathology