Widdrington J, Ashfaq I, Puvaneswaran B, Ong E L, Schwab U, Price D A, Schmid M L, Pandit R
J Widdrington, Department of Infection and Tropical Medicine, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK. Email:
J R Coll Physicians Edinb. 2017 Jun;47(2):129-134. doi: 10.4997/JRCPE.2017.204.
The incidence of syphilis in the UK is rapidly rising. Uveitis (intraocular inflammation) usually occurs in the secondary or later stages of syphilis infection and is sight-threatening. Methods A retrospective analysis of the demographics, presentation, diagnosis, treatment and outcomes of patients with syphilitic uveitis managed in Newcastle from 2005-2016 was carried out. Results Ten males (19 eyes) with syphilitic uveitis had a generally good visual and serological response to penicillin treatment. In eight of the patients there had been a failure to test for syphilis during assessments by various medical practitioners for unexplained symptoms that were attributable to syphilis prior to the eye involvement. Conclusion Uveitis associated with syphilis can be sight-threatening but responds well to treatment. In our case series there were multiple missed opportunities to diagnose syphilis prior to presentation with eye disease, with a general failure of healthcare professionals to take an adequate sexual history.
英国梅毒发病率正在迅速上升。葡萄膜炎（眼内炎症）通常发生在梅毒感染的二期或更晚期，会威胁视力。方法 对2005年至2016年在纽卡斯尔接受治疗的梅毒相关性葡萄膜炎患者的人口统计学、临床表现、诊断、治疗及预后进行回顾性分析。结果 10名患有梅毒相关性葡萄膜炎的男性（19只眼）对青霉素治疗的视觉和血清学反应总体良好。其中8名患者在眼科受累之前，因各种原因不明的症状接受不同医生评估时，均未进行梅毒检测，而这些症状后来被证实由梅毒引起。结论 梅毒相关性葡萄膜炎可威胁视力，但对治疗反应良好。在我们的病例系列中，在出现眼部疾病之前，有多次错过诊断梅毒的机会，医疗保健专业人员普遍未能获取充分的性病史。
