Don't Forget What You Can't See: A Case of Ocular Syphilis

Monica I. Lee, Annie W.C. Lee, Sean M. Sumsion, Julie A. Gorchynski

Research output: Contribution to journalArticle

Abstract

This case describes an emergency department (ED) presentation of ocular syphilis in a human immunodeficiency virus (HIV) infected patient. This is an unusual presentation of syphilis and one that emergency physicians should be aware of. The prevalence of syphilis has reached epidemic proportions since 2001 with occurrences primarily among men who have sex with men (MSM). This is a case of a 24-year-old male who presented to our ED with bilateral painless vision loss. The patient's history and ED workup were notable for MSM, positive rapid plasmin reagin (RPR) and HIV tests and fundus exam consistent with ocular syphilis, specifically uveitis. Ocular manifestations of syphilis can present at any stage of syphilis. The 2010 Centers for Disease Control and Prevention guidelines now recommend that ocular syphilis be treated as neurosyphilis regardless of the lumbar puncture results. There is a paucity of emergency medicine literature on ocular syphilis. For emergency physicians it is important to be aware of iritis, uveitis, or chorioretinitis as ocular manifestations of neurosyphilis especially in this high-risk population and to obtain RPR and HIV tests in the ED to facilitate early diagnosis, and treatment and to prevent irreversible vision loss.

Original languageEnglish (US)
Pages (from-to)473-476
Number of pages4
JournalWestern Journal of Emergency Medicine
Volume17
Issue number4
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

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Syphilis
Hospital Emergency Service
Eye Manifestations
Reagins
Neurosyphilis
Fibrinolysin
Uveitis
HIV
Emergencies
Chorioretinitis
Iritis
Physicians
Spinal Puncture
Emergency Medicine
Centers for Disease Control and Prevention (U.S.)
Early Diagnosis
Guidelines
Population

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Don't Forget What You Can't See : A Case of Ocular Syphilis. / Lee, Monica I.; Lee, Annie W.C.; Sumsion, Sean M.; Gorchynski, Julie A.

In: Western Journal of Emergency Medicine, Vol. 17, No. 4, 01.01.2016, p. 473-476.

Research output: Contribution to journalArticle

Lee, Monica I. ; Lee, Annie W.C. ; Sumsion, Sean M. ; Gorchynski, Julie A. / Don't Forget What You Can't See : A Case of Ocular Syphilis. In: Western Journal of Emergency Medicine. 2016 ; Vol. 17, No. 4. pp. 473-476.
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