Título

PANUVEITIS SECONDARY TO SYPHILIS: A CASE REPORT

Introdução / Purpose

To report a case and discuss the topic.

Material e Método / Methods

Case report with analysis of medical records from João Penido Burnier´s Foundation. A 66-year-old male came to our service complaining about an acute episode of decreased vision and pain in the right eye (OD),he is diabetic and denies ophthalmological antecedents. Visual acuity with best correction was counting fingers (OD)and 20/25 in the left eye (OS). Biomicroscopy revealed conjunctival hyperemia +2/+4 and cells inflammation in anterior chamber (AC)+4/+4 with keratic precipitates. Intraocular pressure was 16mmHg andfundus examination showed +3/+4 of vitreous haze, snows-balls and snow-bank on the periphery. There were no remarkable findings in OS. Treatment with topical steroids and mydriatics was started and screening blood for chorioretinitis requested, which returned positive for syphilis (VDRL 1:64 and Treponema IGM +).Patient received systemic treatment with ceftriaxone 2g / day intravenously for 14 days and was followed weekly by ophthalmologist and infectologist.

Resultados / Results

After 2 months, there was no signal of uveitis, just Vossius Ring in AC, and the visual acuity was 20/100(OD).

Discussão e Conclusões / Discussion

Although previously rare, syphilis remains an important cause of ocular disease, with recent increasing trend1, 2. Uveitis is the most common ocular manifestation of syphilis, and it can present in all stages of the disease; so it must always be in the etiological investigation3,4. Anterior uveitis may be granulomatous or non-granulomatous and posterior segment involvement may include vitritis, retinitis, retinal vasculitis and papillitis1.Diagnosis is centered around a clinical suspicion and includes treponemal specific and non-treponemal serologic tests; all patients with newly diagnosed syphilis should be tested for co-infection with human immunodeficiency virus5. Treatment of ocular syphilis is that of neurosyphilis and the early therapy provides a good visual prognosis6.

Palavras Chave

Syphilis; Panuveitis; uveitis

Area

CLINICAL RETINA