Atypical presentation of ocular syphilis in an individual with AIDS.

نویسندگان

Paulo Sérgio Ramos de Araujo

Sandra Dias

Fabiana Gonzaga

چکیده

Ocular complications are common in acquired immunodefi ciency syndrome (AIDS) and occur in 50-75% of patients throughout the course of their illness. Syphilis is the most common bacterial eye infection in these patients and most often presents as uveitis or an optic nerve disease. This condition can manifest as episcleritis, scleritis, dacryoadenitis, anterior uveitis, intermediate uveitis, papillitis, retinal vasculitis, neuroretinitis, or retrobulbar optic neuropathy. The most common symptoms include blurred vision, loss of vision, central scotoma, and bilateral ocular involvement. Although most patients with ocular syphilis do not present with clinical fi ndings, such fi ndings have a high positive predictive value. Patches of creamy, diffuse retinitis with overlying punctate and superfi cial retinal precipitates have been described as presentations suggestive of ocular syphilis (Figure A). This clinical condition may represent the clinician’s fi rst opportunity to diagnose human immunodefi ciency virus (HIV) infection and tends to be more severe in individuals who are not yet receiving antiretroviral therapy.

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