Posters

Syphilis in a complicated cataract

Poster Details

First Author: F.March De Ribot SPAIN

Co Author(s):    A. March de ribot   Á. Giménez   S. Ayats   J. Tarrús   T. Torrent   F. Escalada     

Abstract Details

Purpose:

Ocular syphilis is a neurosyphilis that can mimic a variety of ocular diseases, most commonly uveitis, but also interstitial keratitis, chorioretinitis,retinitis, retinal vasculitis and optic, and cranial neuropathies.

Setting:

Ophthalmology Department, University Hospital

Methods:

An 87-year-old male arrived in the emergency department complaining about the loss of visual acuity of the right eye after complicated cataract surgery 3 months before. The geriatric patient accused of secondary depression and loss of orientation. The left eye was amblyope. The visual acuity was RE HM, LE CF. The anterior segment presented RE iris atrophy and pseudophakia, cataract. The retina presented general senile atrophy with pigmentary changes in the macula of both eyes. The previous studies revealed macular edema of RE after the surgery that was not present at the moment of the exploration.

Results:

The patient was orientated as Irvine Gasssyndrome and was in treatment with topical corticoids, and AINES. We consider a different scenario. The diagnostic approach was Acute syphilitic posterior placoid chorioretinitis. The OCT presented typical hyperreflective alterations to the photoreceptor layer. The patient had psoriasis-like lesions in hands, palms, and plants. Theserologies revealed VDRL, FTA +, and HIV-, neutrophils were present in cerebrospinal fluid. After that, the patient confessed recent sexual relations with a prostitute. Treatment with penicillin 4mUI 4hfor 14 days. Evolution improved VA and the general condition of the patient.

Conclusions:

Syphilis is a multisystem, chronic bacterial infection that can affect multiple organ systems, including skin, heart, blood vessels, bones, nervous system, and eye leading to various clinical manifestations. Transmission occurs most often during sexual contact, especially in men who have sex with men and people infected with HIV. Syphilis is one of the great masqueraders and has to be considered even in improbable presentations.  

Financial Disclosure:

None