Vignesh A P, Srinivasan R, Vijitha Sai
Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India.
Taiwan J Ophthalmol. 2016 Oct-Dec;6(4):204-205. doi: 10.1016/j.tjo.2016.06.002. Epub 2016 Jul 16.
Ocular syphilis has varied manifestations in the eye. Peripheral ulcerative keratitis (PUK) is a crescent-shaped ulcer involving the peripheral cornea and associated with thinning. PUK is caused by both autoimmune and infectious diseases, such as rheumatoid arthritis, tuberculosis, and herpes. Here, we report a rare case of bilateral PUK caused by syphilis. A 55-year-old man presented with recurrent pain and redness in both eyes for 2 months. The cornea of both eyes had bilateral peripheral crescent-shaped ulcers suggestive of PUK. The patient was started on topical steroids elsewhere, but the lesion was not showing any signs of healing. A series of investigations were performed, with positive venereal disease research laboratory and fluorescent treponemal antibody absorption tests. The patient was then started on systemic penicillin, as well as topical steroids. The response to the treatment was good and the ulcer began to heal. PUK as the presenting feature of acquired syphilis is a rare scenario. Such infective causes should be managed with systemic antimicrobials for optimal outcomes.
眼部梅毒在眼部有多种表现。周边溃疡性角膜炎（PUK）是一种累及周边角膜并伴有变薄的新月形溃疡。PUK由自身免疫性疾病和感染性疾病引起，如类风湿性关节炎、结核病和疱疹。在此，我们报告一例罕见的由梅毒引起的双侧PUK病例。一名55岁男性双眼反复疼痛、发红2个月。双眼角膜有双侧周边新月形溃疡，提示为PUK。该患者在其他地方开始使用局部类固醇治疗，但病变未显示任何愈合迹象。进行了一系列检查，性病研究实验室检查和荧光密螺旋体抗体吸收试验均为阳性。然后该患者开始接受全身性青霉素治疗以及局部类固醇治疗。治疗反应良好，溃疡开始愈合。PUK作为获得性梅毒的首发特征是一种罕见情况。对于此类感染性病因，应使用全身性抗菌药物进行治疗以获得最佳疗效。
