title: Delayed diagnosis of ocular syphilis that manifested as retinal vasculitis and acute posterior multifocal placoid epitheliopathy.
abstract: A 55-year-old female presented with bilateral progressive retinal vasculitis. She was on systemic and intravitreal steroids on the basis of uveitis work-up result (negative result including rapid plasma reagin), but her visual acuity continued to deteriorate to light perception only. Ocular examination showed retinal vasculitis, multiple yellow placoid lesions and severe macula edema in both eyes. Repeated work-up revealed positivity of fluorescent treponemal antibody-absorption in serum and subsequently in cerebrospinal fluid. Ocular syphilis was diagnosed. And intravenous penicillin G resulted in rapid resolution of vasculitis and macular edema. To avoid delay in the diagnosis of ocular syphilis, high index of suspicion and repeating serological tests (including both treponemal and non-treponemal tests) are warranted.
authors.forename: Jong Hoon
authors.initials: JH
authors.lastname: Park
authors.forename: Soo Geun
authors.initials: SG
authors.lastname: Joe
authors.affiliation: Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Young Hee
authors.initials: YH
authors.lastname: Yoon
mesh_terms: D000208:Acute Disease; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D015818:Eye Infections, Bacterial / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000473:pathology*; D031300:Retinal Vasculitis / Q000175:diagnosis* / Q000209:etiology; D013587:Syphilis / Q000150:complications / Q000175:diagnosis*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity