Bouisse V, Cochereau-Massin I, Jobin D, Lautier-Frau M, Barry M, Le Hoang P, Rousselie F
Service d'Ophtalmologie, Hôpital de la Pitié-Salpétrière, Paris.
J Fr Ophtalmol. 1991;14(11-12):605-9.
Ocular syphilis is rare in human immunodeficiency virus infected individuals. We think that syphilis should be considered in evaluating such patients presenting with uveitis. Most often, ocular syphilis includes retinitis associated with anterior or posterior uveitis, sometimes with optic neuritis. Concurrent neurosyphilis is frequent and may be more aggressive; it may progress more rapidly and cause more atypical signs than in patients without human immunodeficiency virus infection. This suggests the need for lumbar puncture in the evaluation of coinfected patients. The standard serological tests for syphilis (in blood and cerebrospinal fluid) may be nonreactive in human immunodeficiency virus seropositive patients. It may be because of the alteration of immunologic response of such patients. All coinfected patients with human immunodeficiency virus and syphilis should be treated with high-dose intravenous penicillin G sodium as recommended for neurosyphilis. We describe two human immunodeficiency virus infected patients with ocular syphilis and neurosyphilis.
眼部梅毒在人类免疫缺陷病毒感染个体中较为罕见。我们认为，在评估此类患有葡萄膜炎的患者时应考虑梅毒。眼部梅毒最常见的表现包括与前葡萄膜炎或后葡萄膜炎相关的视网膜炎，有时还伴有视神经炎。同时合并神经梅毒很常见，且可能更具侵袭性；与未感染人类免疫缺陷病毒的患者相比，其病情进展可能更快，症状也更不典型。这表明在评估合并感染的患者时需要进行腰椎穿刺。梅毒的标准血清学检测（血液和脑脊液检测）在人类免疫缺陷病毒血清阳性患者中可能无反应。这可能是由于此类患者免疫反应的改变。所有合并感染人类免疫缺陷病毒和梅毒的患者都应按照神经梅毒的推荐方案，用大剂量静脉注射青霉素G钠进行治疗。我们描述了两名感染人类免疫缺陷病毒且患有眼部梅毒和神经梅毒的患者。
