| Presentation preference | Poster presentation |
| Title | An upsetting asymmetric syphilitic uveitis : watch out for a second train |
| Purpose | Over the last decade, the prevalence of syphilis and its related complications has significantly increased. We aimed to report a case of syphilis with diverse and asymetric ocular manifestations in an immunocompetent patient. |
| Methods | Case report. |
| Results | A 40-year-old male presented with a one-week history of pain and blurred vision on the right eye. Visual acuity (VA) was hand motion. Ocular examination found a panuveitis with iris vascular engorgement, an hyphema and fundus bad visualisation. Ophtalmologic examination of the left eye was normal. The anamnesis found neither uveitis risk factors nor sexual risky behaviour. The etiological study revealed the diagnosis of syphilis, the brain MRI and CSF analysis reported a lymphocytic meningitis. A course of intravenous penicillin and local steroids was initiated, which decreased the vitritis, allowed us to observe the retina and thus perform further imaging tests. OCT, fundus autofluorescence and fluorescein angiography demonstrated a bilateral acute syphilitic posterior placoid chorioretinitis with papillitis, and on the right eye, a diffuse vasculitis with a superotemporal branch artery occlusion. Improvement of VA was rapidly obtained under treatment. |
| Conclusion | We present a case of syphilis with a wide range of ocular manifestations well-documented by multimodal imaging. It is an original case with monocular symptoms despite the bilateral involvement. This shows the importance and diagnostic help of a good examination of the asymptomatic eye in cases of ocular inflammation. It also highlights the relevance of a routine screening for syphilis, due to its clinical pleomorphism and potential aggressiveness, but reversibility with prompt treatment. |
| Conflict of interest | No |
Authors 1
| Last name | MAESTRI |
| Initials of first name(s) | F |
| Department | Ophtalmologie, Pitié Salpêtrière |
| City | Paris |
| Country | France |
Authors 2
| Last name | GOUNOU MOTCHOFO |
| Initials of first name(s) | A |
| Department | Ophtalmologie, Pitié Salpêtrière |
| City | Paris |
| Country | France |
Authors 3
| Last name | XAVIER |
| Initials of first name(s) | C |
| Department | Ophtalmologie, Pitié Salpêtrière |
| City | Paris |
| Country | France |
Authors 4
| Last name | BODAGHI |
| Initials of first name(s) | B |
| Department | Ophtalmologie, Pitié Salpêtrière |
| City | Paris |
| Country | France |
