Department of Neurology, Ophthalmology and Genetics, San Martino Hospital, University of Genoa, Via De Toni 5, 16132, Genoa, Italy.
Neurol Sci. 2010 Jun;31(3):365-7. doi: 10.1007/s10072-010-0222-8. Epub 2010 Feb 25.
Neurosyphilis is still a significant medical problem in developing countries and syphilitic ocular manifestations are often not diagnosed due to the lack of typical characteristics. We describe the case of a 59-year-old homosexual man with a 1-month history of decreased vision acuity in his left eye who was diagnosed with neurosyphilis and received treatment with intravenous penicillin G (16 million units in divided daily doses), with great improvement of visual acuity and CSF examination findings. The interest of this case is not only represented by the unusually early ocular involvement, but also by the rapid evolution of the disease into the secondary stage in a man who had had one at-risk homosexual relationship only 3 months before the onset symptoms. We also support the view that the presence of ocular involvement in syphilitic patients is suggestive of involvement of the CNS and should be considered synonymous with neurosyphilis.
神经梅毒在发展中国家仍是一个重大的医学问题，由于缺乏典型特征，梅毒眼部表现常常得不到诊断。我们描述了 1 例 59 岁同性恋男性病例，他左眼视力下降 1 个月，被诊断为神经梅毒，并接受了静脉注射青霉素 G（1600 万单位，每日分剂量）治疗，视力和脑脊液检查结果均有很大改善。该病例的意义不仅在于眼部受累异常早，还在于仅在出现症状前 3 个月有过 1 次高危同性恋接触的患者，疾病迅速发展为二期。我们还支持这样一种观点，即梅毒患者出现眼部受累提示中枢神经系统受累，应视为神经梅毒的同义词。
