Older woman with abdominal pain and bilateral sequential vision loss due to syphilis
| Autor: | Edward Margolin, Alexander J. Kaplan, Esther Bui, Trishal Jeeva-Patel, Anna Kabanovski |
|---|---|
| Rok vydání: | 2023 |
| Předmět: |
medicine.medical_specialty
Abdominal pain Visual acuity genetic structures Optic Disk Vision Disorders Visual Acuity Case Report Syphilis infection 03 medical and health sciences 0302 clinical medicine medicine Humans Syphilis Ocular inflammation Aged business.industry General Medicine Middle Aged medicine.disease eye diseases Surgery Elevated alkaline phosphatase Abdominal Pain Optic nerve pallor medicine.anatomical_structure 030221 ophthalmology & optometry 030211 gastroenterology & hepatology Female sense organs medicine.symptom business Optic disc |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| Popis: | A 62-year-old woman presented with non-specific abdominal pain, elevated alkaline phosphatase levels and bilateral sequential visual loss. Visual acuity was counting fingers in right eye (RE) and 20/400 in left eye (LE). She was noted to have optic nerve pallor in RE and mildly elevated optic disc with signs of ocular inflammation in LE. After 2 weeks, vision deteriorated to light perception bilaterally with now extensive vitreal inflammation present in both eyes. Positive rapid plasma reagen and Treponema pallidum’s antibody tites confirmed syphilis infection. Unfortunately, as the diagnosis was delayed by many months, her visual acuity remained poor (hand motions in RE and 20/50 in LE) despite treatment with intravenous penicillin. This case reminds us of the re-emergence of this ‘great masquerader’ and highlights the importance of maintaining high suspicion for syphilis in patients with unexplained visual loss and systemic symptoms, even in older adults without identifiable risk factors. |
| Databáze: | OpenAIRE |
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