Ocular manifestations of syphilis: recent cases over a 2.5-year period
| Autor: | Christophe Chiquet, Max Maurin, Patricia Pavese, Jean-Paul Romanet, Stéphane Gennai, Isabelle Pelloux, Cindy Puech |
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| Přispěvatelé: | Physiologie cardio-Respiratoire Expérimentale Théorique et Appliquée (TIMC-IMAG-PRETA), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Service des Maladies Infectieuses, CHU Grenoble, Laboratoire de Bactériologie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Laboratoire Adaptation et pathogénie des micro-organismes [Grenoble] (LAPM), Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Department of Ophtalmology, Université Joseph Fourier - Grenoble 1 (UJF) |
| Rok vydání: | 2010 |
| Předmět: |
Male
genetic structures MESH: CD4 Lymphocyte Count Human immunodeficiency virus (HIV) Fluorescent Antibody Technique HIV Infections Syphilis infection medicine.disease_cause MESH: Syphilis Serodiagnosis Eye Infections Bacterial MESH: Panuveitis 0302 clinical medicine Panuveitis 030212 general & internal medicine MESH: Doxycycline MESH: Fluorescent Antibody Technique MESH: Aged MESH: Middle Aged MESH: Eye Infections Bacterial [SDV.BID.EVO]Life Sciences [q-bio]/Biodiversity/Populations and Evolution [q-bio.PE] Ceftriaxone MESH: HIV Infections Middle Aged Sensory Systems 3. Good health MESH: Optic Neuritis Anti-Bacterial Agents Doxycycline Uveitis Beta lactam antibiotics Adult medicine.medical_specialty Optic Neuritis Ocular syphilis Macular Edema 03 medical and health sciences Cellular and Molecular Neuroscience MESH: Macular Edema MESH: Anti-Bacterial Agents medicine Humans Syphilis MESH: Chorioretinitis Aged Retrospective Studies MESH: Humans business.industry MESH: Adult MESH: Retrospective Studies medicine.disease Dermatology eye diseases MESH: Male MESH: Ceftriaxone CD4 Lymphocyte Count Syphilis Serodiagnosis Ophthalmology Chorioretinitis MESH: Syphilis Immunology 030221 ophthalmology & optometry sense organs business MESH: Scleritis Scleritis |
| Zdroj: | Graefe's Archive for Clinical and Experimental Ophthalmology Graefe's Archive for Clinical and Experimental Ophthalmology, Springer Verlag, 2010, 248 (11), pp.1623-9. ⟨10.1007/s00417-010-1481-z⟩ |
| ISSN: | 1435-702X 0721-832X |
| DOI: | 10.1007/s00417-010-1481-z⟩ |
| Popis: | International audience; BACKGROUND: The ocular manifestations of syphilis are protean and can affect every structure of the eye. There has been a recent increase of syphilis infection in Europe. We report recent cases of ocular syphilis infection in a tertiary center. METHODS: During a 2.5-year period (2005-2007) we collected the medical records of eight male patients with ocular syphilis. The diagnosis was based on serological tests on blood samples and cerebrospinal fluid. All patients underwent a check-up to rule out another etiological diagnosis and to detect the presence of any other sexually transmitted infections. RESULTS: The ocular lesions included: chorioretinitis (one case), retinitis (two cases), panuveitis with macular edema (two cases), episcleritis (one case), anterior optic neuritis (one case), and retrobulbar optic neuropathy (one case). Infection of the cerebrospinal fluid was detected in three of the five patients tested. In six cases, the inflammation was unilateral, and the anatomical and functional prognosis was excellent at the 6-month follow-up visit. Co-infection with human immunodeficiency virus was reported in five patients, with a CD4 T lymphocyte count greater than 300/mm(3). Most of the patients were treated with parenteral ceftriaxone (1 g daily) for 3 weeks with good tolerance. One patient was treated with intravenous penicillin G (18 MUI daily). Only one patient with anterior optic neuritis required systemic steroid therapy associated with antibiotics. Sequelae included sectorial atrophy of the optic nerve with visual field loss (n = 1) and abnormalities of the retinal pigment epithelium (n = 3). CONCLUSIONS: All patients with ocular syphilis exhibited functional improvement and resolution of ocular inflammation after a specific antibiotic treatment. As a great imitator, syphilis should be considered in all patients with uveitis, scleritis, episcleritis, or optic neuritis, especially in men with high-risk sexual behavior. |
| Databáze: | OpenAIRE |
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