Don't Forget What You Can't See: A Case of Ocular Syphilis
General Material Designation
[Article]
First Statement of Responsibility
Lee, Monica I.; Lee, Annie Wan Ching W.C.; Sumsion, Sean M.; Gorchynski, Julie A.
SUMMARY OR ABSTRACT
Text of Note
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.
SET
Date of Publication
2016
Title
Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
Volume Number
17/4
PERSONAL NAME - PRIMARY RESPONSIBILITY
Entry Element
Lee, Monica I.; Lee, Annie Wan Ching W.C.; Sumsion, Sean M.; Gorchynski, Julie A.