Título

OCULAR SYPHILIS - A DISTINCT CASE

Introdução / Purpose

Sífilis was first recognized in 15th century1 This sexually transmitted disease caused by Treponema pallidum. has experienced a worldwide increase in its incidence 1-9 especially in individuals with HIV
coinfection1-6.
Purpose To produce knowledge about ocular syphilis manifestations through a clinical case report.

Material e Método / Methods

Descriptive study based on data obtained through anamnesis, physical examination and examinations associated with literature review.

Resultados / Results

Case Report Male,40 years, sought ophthalmologic care in the Retina department of the Antônio Pedro University Hospital of the Faculty of Medicine of the Fluminense Federal University complaining of metamorphopsia in OD. The exam presented visual acuity(VA) in right eye (RE) 20/30 and left eye (LE) 20/20. Biomicroscopy without changes. Fundoscopy: two small and yellowish lesions on the macula of OD. Autofluorescence and OCT were performed, which showed no alterations. In the fluorescein angiography the foveal anatomy was slightly altered. Visual acuity continued to decline reaching 20/50 in OD. At that moment, the fundoscopy was unchanged. Serologies with VDRL and FTA-ABS positive were requested. Subsequently, the study was completed with a lumbar punc-ture that confirmed positive VDRL in the cerebrospinal fluid(CSF).
He was hospitalized in the infectious sector of the same hospital for treatment with crystalline penicillin for 21 days. After treatment, the patient presented VA of 20/20 OU, complaining of small central scotoma in OD. Post-treatment retinography maintained macular lesions.

Discussão e Conclusões / Discussion

Syphilis is a very old disease, but its recent increase in the number of cases has brought it new attention. Ocular syphilis is considered a great mimicker due to their different forms of presentation. Thus, with the increasing incidence of ocular syphilis, it should always be considered in the differential diagnosis of low visual acuity.

Palavras Chave

infectious diseases, retina, syphilis, uveitis