Parker Sarah E, Pula John H
Neuro-ophthalmology Unit, University of Illinois College of Medicine at Peoria, 530 NE Glen Oak Avenue, Peoria, IL 61611, USA.
Case Rep Ophthalmol Med. 2012;2012:621872. doi: 10.1155/2012/621872. Epub 2012 Feb 26.
Introduction. Syphilis is a sexually transmitted disease that is known as "the great imitator" due to its wide variety of clinical presentations, including ocular disorders. There has been an increase in the rate of syphilis in the United States, especially in persons with HIV. We report a case of optic perineuritis in an asymptomatic male secondary to central nervous system (CNS) syphilis. Case Report. A 41-year-old man was found to have bilateral disc edema on a routine exam. Brain MRI was unremarkable, and lumbar puncture revealed a normal opening pressure, with an elevated cerebrospinal fluid white cell count. Orbit MRI showed optic nerve sheath expansion and enhancement, consistent with optic perineuritis. He tested positive for syphilis based on serum RPR and FTA-ABS. Conclusion. Ophthalmologic findings, including disc edema, may be the presenting features of CNS syphilis. Even in asymptomatic persons, perineuritis should be considered early, as diagnosis and treatment are imperative given the progressive nature of the disease.
引言。梅毒是一种性传播疾病，因其临床表现多样，包括眼部疾病，而被称为“伟大的模仿者”。美国梅毒发病率有所上升，尤其是在艾滋病毒感染者中。我们报告一例无症状男性继发于中枢神经系统（CNS）梅毒的视神经周围炎病例。病例报告。一名41岁男性在常规检查中被发现双侧视盘水肿。脑部MRI无异常，腰椎穿刺显示初压正常，但脑脊液白细胞计数升高。眼眶MRI显示视神经鞘扩张和强化，符合视神经周围炎表现。根据血清RPR和FTA-ABS检测，他的梅毒检测呈阳性。结论。眼科检查结果，包括视盘水肿，可能是CNS梅毒的首发特征。即使是无症状者，也应尽早考虑视神经周围炎，鉴于该疾病的进展性，诊断和治疗至关重要。
