The First Reported Case of Ocular Syphilis in an Iranian Patient
Abstract Purpose: To report the first case of ocular syphilis in an Iranian patient and discuss its diagnostic challenges. Case Report: A man in his mid-70s presented with progressive bilateral visual and auditory decline. He had previously lived in a Southeast Asian country for 10 years. Prior ster...
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| Format: | Article |
| Language: | English |
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Knowledge E
2023-11-01
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| Series: | Journal of Ophthalmic & Vision Research |
| Subjects: | |
| Online Access: | https://doi.org/10.18502/jovr.v18i4.14559 |
| _version_ | 1797361072526589952 |
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| author | Sahba Fekri Shahram Salehi-Rad Hosein Nouri Shabnam Tehrani Bita Shalbafan Seyed-Hossein Abtahi |
| author_facet | Sahba Fekri Shahram Salehi-Rad Hosein Nouri Shabnam Tehrani Bita Shalbafan Seyed-Hossein Abtahi |
| author_sort | Sahba Fekri |
| collection | DOAJ |
| description | Abstract Purpose: To report the first case of ocular syphilis in an Iranian patient and discuss its diagnostic challenges. Case Report: A man in his mid-70s presented with progressive bilateral visual and auditory decline. He had previously lived in a Southeast Asian country for 10 years. Prior steroid therapies entailed no inflammation subsidence. His visual acuity at presentation was light perception OU. Funduscopic findings included severe vitritis, severe optic atrophy, diffuse retinal vascular occlusion, and diffuse retinal atrophy OU. Angiography demonstrated diffuse areas of retinal and choriocapillaris atrophy with no active choroiditis. Scaly cutaneous lesions were noted on his palms and soles – atypical findings of secondary syphilis. Serum analysis revealed an underlying syphilis infection. The cerebrospinal fluid sample was reactive to anti-syphilis antibodies, securing a neurosyphilis diagnosis. Two weeks of antibiotic therapy resulted in cutaneous lesions resolution and relative visual improvement despite extensive baseline retinal atrophic damage. Conclusion: Ocular syphilis can mimic numerous ocular inflammatory scenarios. In cases of ocular inflammation that is unresponsive to steroids, reconsidering alternative diagnoses, especially infections with the highest clinical relevance, is necessary. We stress the importance of acquiring patients' sexual history, regardless of cultural barriers and the rarity of the entity in some regions. |
| first_indexed | 2024-03-08T15:48:41Z |
| format | Article |
| id | doaj.art-5d9b86068d5a4dfc93b46f888c4d9cf1 |
| institution | Directory Open Access Journal |
| issn | 2008-2010 2008-322X |
| language | English |
| last_indexed | 2024-03-08T15:48:41Z |
| publishDate | 2023-11-01 |
| publisher | Knowledge E |
| record_format | Article |
| series | Journal of Ophthalmic & Vision Research |
| spelling | doaj.art-5d9b86068d5a4dfc93b46f888c4d9cf12024-01-09T07:54:41ZengKnowledge EJournal of Ophthalmic & Vision Research2008-20102008-322X2023-11-0118445245710.18502/jovr.v18i4.14559jovr.v18i4.14559The First Reported Case of Ocular Syphilis in an Iranian PatientSahba Fekri0Shahram Salehi-Rad1Hosein Nouri2Shabnam Tehrani3Bita Shalbafan4Seyed-Hossein Abtahi5 Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Clinical Research Development Center of Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, IranAbstract Purpose: To report the first case of ocular syphilis in an Iranian patient and discuss its diagnostic challenges. Case Report: A man in his mid-70s presented with progressive bilateral visual and auditory decline. He had previously lived in a Southeast Asian country for 10 years. Prior steroid therapies entailed no inflammation subsidence. His visual acuity at presentation was light perception OU. Funduscopic findings included severe vitritis, severe optic atrophy, diffuse retinal vascular occlusion, and diffuse retinal atrophy OU. Angiography demonstrated diffuse areas of retinal and choriocapillaris atrophy with no active choroiditis. Scaly cutaneous lesions were noted on his palms and soles – atypical findings of secondary syphilis. Serum analysis revealed an underlying syphilis infection. The cerebrospinal fluid sample was reactive to anti-syphilis antibodies, securing a neurosyphilis diagnosis. Two weeks of antibiotic therapy resulted in cutaneous lesions resolution and relative visual improvement despite extensive baseline retinal atrophic damage. Conclusion: Ocular syphilis can mimic numerous ocular inflammatory scenarios. In cases of ocular inflammation that is unresponsive to steroids, reconsidering alternative diagnoses, especially infections with the highest clinical relevance, is necessary. We stress the importance of acquiring patients' sexual history, regardless of cultural barriers and the rarity of the entity in some regions.https://doi.org/10.18502/jovr.v18i4.14559syphilisneurosyphilisbacterial ocular infectionuveitis |
| spellingShingle | Sahba Fekri Shahram Salehi-Rad Hosein Nouri Shabnam Tehrani Bita Shalbafan Seyed-Hossein Abtahi The First Reported Case of Ocular Syphilis in an Iranian Patient Journal of Ophthalmic & Vision Research syphilis neurosyphilis bacterial ocular infection uveitis |
| title | The First Reported Case of Ocular Syphilis in an Iranian Patient |
| title_full | The First Reported Case of Ocular Syphilis in an Iranian Patient |
| title_fullStr | The First Reported Case of Ocular Syphilis in an Iranian Patient |
| title_full_unstemmed | The First Reported Case of Ocular Syphilis in an Iranian Patient |
| title_short | The First Reported Case of Ocular Syphilis in an Iranian Patient |
| title_sort | first reported case of ocular syphilis in an iranian patient |
| topic | syphilis neurosyphilis bacterial ocular infection uveitis |
| url | https://doi.org/10.18502/jovr.v18i4.14559 |
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