A case of neurosyphilis revealed by acute exudative polymorphous vitelliform maculopathy.
The authors report the case of a healthy 56-year-old man presenting with bilateral vision loss. Clinical features were consistent with the diagnosis of acute exudative polymorphous vitelliform maculopathy (AEPVM). The patient returned 10 days later with bilateral anterior granulomatous uveitis, and the inflammatory work-up revealed treponemal antibodies in the serum and spinal fluid, consistent with a diagnosis of active neurosyphilis. The patient received standard treatment for neurosyphilis with intravenous penicillin G. Two months later, the intraocular inflammation had resolved, but the resolution of the vitelliform lesions was more gradual. An immune process could be a plausible explanation for these clinical findings. Clinicians should be aware that syphilis can produce AEPVM.
Benjamin
B
Wolff
Sarah
S
Mrejen
K Bailey
KB
Freund
Cherif
C
Titah
Martine
M
Mauget-Faÿsse
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood / Q000134:cerebrospinal fluid; D005122:Exudates and Transudates; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009494:Neurosyphilis / Q000175:diagnosis* / Q000188:drug therapy; D010400:Penicillin G / Q000627:therapeutic use; D041623:Tomography, Optical Coherence; D014210:Treponema pallidum / Q000276:immunology; D057826:Vitelliform Macular Dystrophy / Q000175:diagnosis* / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D010400:Penicillin G