Manifestations and treatment of ocular syphilis during an epidemic in France

Sex Transm Dis. 2007 Aug;34(8):553-6. doi: 10.1097/01.olq.0000253385.49373.1a.

Abstract

Objectives: To review cases of ocular syphilis presenting to a tertiary uveitis clinic during a syphilis epidemic in France between January 2001 and January 2004.

Study design: Retrospective chart and patient database review.

Results: Ten patients who presented with symptoms and signs of uveitis tested positive for active syphilis. Some of the patients also presented with a rash or headache. Human immunodeficiency virus (HIV) antibody testing was positive in eight of the 10 patients, with CD4 cell counts >200 cells/mm3 in seven of the patients. Ocular inflammation resolved and visual acuity improved in all patients after treatment.

Conclusions: A diagnosis of ocular syphilis should be considered in any patient with visual loss associated with a rash or headache, irrespective of the patient's CD4 cell count. Ocular syphilis in HIV-positive patients should be treated as neurosyphilis, whereas ocular syphilis in non-HIV patients can be treated as secondary syphilis.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Disease Outbreaks*
  • France / epidemiology
  • HIV Infections / complications
  • Homosexuality, Male
  • Humans
  • Male
  • Medical Records
  • Middle Aged
  • Neurosyphilis / blood
  • Neurosyphilis / complications
  • Neurosyphilis / diagnosis
  • Neurosyphilis / drug therapy
  • Neurosyphilis / epidemiology*
  • Retrospective Studies
  • Syphilis Serodiagnosis
  • Uveitis / complications
  • Uveitis / drug therapy
  • Uveitis / epidemiology*
  • Uveitis / pathology
  • Visual Acuity

Substances

  • Anti-Bacterial Agents