title: Unilateral mydriasis as the primary sign of neurosyphilis.
abstract: Syphilis can mimic most ocular disorders, and there is no characteristic to distinguish ocular syphilis from other eye diseases. We report a rare case of a 41-year-old man who presented with an Adie's-like pupil as the only feature of neurosyphilis. The patient met the criteria for the diagnosis of neurosyphilis by the finding of positive cerebrospinal fluid-Venereal Disease Research Laboratory (CSF-VDRL) and CSF-Treponema pallidum particle agglutination tests. The patient was then treated with 2 g intravenous ceftriaxone per day for 15 days because of penicillin allergy. Nine months after anti-syphilitic treatment alone, the diameter of the patient's left pupil reduced from 10 to 5 mm. The CSF-VDRL test was negative. It is highly recommended that any patients with ocular disease that does not respond to the routine treatment should undergo syphilis evaluation to avoid misdiagnosis.
authors.affiliation: STD Institute, Shanghai Skin Disease Hospital, 200 Wuyi Road, Shanghai, 200050, China.
authors.forename: X
authors.initials: X
authors.lastname: Gu
authors.forename: Z
authors.initials: Z
authors.lastname: Guan
authors.forename: Z
authors.initials: Z
authors.lastname: Chai
authors.forename: P
authors.initials: P
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002308:Cardiolipins / Q000032:analysis; D002443:Ceftriaxone / Q000008:administration & dosage; D002555:Cerebrospinal Fluid / Q000382:microbiology; D002784:Cholesterol / Q000032:analysis; D006801:Humans; D007841:Latex Fixation Tests; D008297:Male; D015878:Mydriasis / Q000175:diagnosis* / Q000209:etiology*; D009494:Neurosyphilis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D010713:Phosphatidylcholines / Q000032:analysis; D016896:Treatment Outcome; D014210:Treponema pallidum / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D002308:Cardiolipins; D010713:Phosphatidylcholines; C054448:VDRL antigen; D002443:Ceftriaxone; D002784:Cholesterol
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