Rath Thomas, Scheel Martin, Kriegel Matthias, Heiligenhaus Arnd
Rheumatologie, St. Franziskus-Hospital Münster.
Uveitiszentrum, Augenzentrum am St. Franziskus-Hospital Münster.
Klin Monbl Augenheilkd. 2020 May;237(5):605-613. doi: 10.1055/a-1126-8970. Epub 2020 May 20.
Syphilis is a bacterial infectious disease transmitted by the spirochaete Treponema pallidum. The rate of infection has increased during the last decade. Ocular syphilis is an underestimated presentation of the disease, and it is increased in HIV-positive patients. Even though every part of the eye may be affected, syphilis most commonly occurs with posterior or panuveitis. A distinctive pattern is acute syphilitic placoid chorioretinitis, with typical features in multimodal imaging. If syphilis is suspected, specific and nonspecific Treponema pallidum serological diagnostic tests are mandatory. Clinical outcome, or morphology and vision are commonly improved if antibiotic therapy (penicillin is the drug of choice) is instituted early. Additional corticosteroids are carefully applied according to individual need, and should be initiated after the start of antibiotics.
梅毒是一种由梅毒螺旋体传播的细菌性传染病。在过去十年中，感染率有所上升。眼部梅毒是该疾病一种被低估的表现形式，在HIV阳性患者中有所增加。尽管眼睛的各个部位都可能受到影响，但梅毒最常表现为后部或全葡萄膜炎。一种独特的类型是急性梅毒性扁平苔藓样脉络膜视网膜炎，在多模态成像中有典型特征。如果怀疑患有梅毒，必须进行特异性和非特异性梅毒螺旋体血清学诊断测试。如果早期开始抗生素治疗（青霉素是首选药物），临床结果、形态或视力通常会得到改善。根据个体需要谨慎使用额外的皮质类固醇，且应在开始使用抗生素后开始使用。
