Trevelyan Gareth, Kumar Kartik, Russell Georgina K, Wickremasinghe Melissa
Department of Respiratory Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
BMJ Case Rep. 2019 Sep 18;12(9):e230341. doi: 10.1136/bcr-2019-230341.
Syphilis infection has shown a marked resurgence over the past several years. Ocular involvement is a rare complication of syphilis, occurring in approximately 1% of cases. We present the case of a man in his 50s who presented to hospital with acute unilateral vision loss and a widespread maculopapular rash. Ophthalmological examination showed unilateral optic disc swelling and bilateral vitritis. Intracranial imaging revealed no acute pathology. Initial blood tests were normal apart from mildly elevated inflammatory markers. A comprehensive autoimmune and infection screen revealed positive syphilis serology. The patient was subsequently treated for syphilis with ocular involvement with a course of intravenous benzylpenicillin, resulting in rapid symptomatic improvement. This case highlighted the importance of considering syphilis infection as part of the differential diagnosis for unexplained multisystemic symptoms, such as loss of vision in combination with dermatological involvement.
梅毒感染在过去几年中显著复发。眼部受累是梅毒罕见的并发症，约1%的病例会出现。我们报告一例50多岁男性，因急性单侧视力丧失和广泛的斑丘疹性皮疹入院。眼科检查显示单侧视盘肿胀和双侧玻璃体炎。颅内影像学检查未发现急性病变。除炎症指标轻度升高外，初始血液检查正常。全面的自身免疫和感染筛查显示梅毒血清学呈阳性。该患者随后接受了静脉注射苄星青霉素治疗梅毒合并眼部受累，症状迅速改善。该病例强调了将梅毒感染作为不明原因多系统症状（如视力丧失合并皮肤受累）鉴别诊断的一部分的重要性。
