Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.
Eur J Ophthalmol. 2024 Mar;34(2):NP108-NP112. doi: 10.1177/11206721231206441. Epub 2023 Oct 10.
Syphilis has historically been referred to as "the great imitator", for the extent of disease manifestations secondary to infection. Ocular manifestations include a wide range of intra-ocular inflammation.
In this study, we report the case of a 52 years-old male patient with syphilitic hemorrhagic necrotizing retinitis.
The patient presented to the emergency room for rapid and progressive vision loss and ocular redness lasting three weeks and was under immunosuppressive treatment. The diagnosis was syphilitic hemorrhagic necrotizing retinitis mimicking the typical clinical picture of retinitis caused by Cytomegalovirus infection in immunocompromised patients.
The presented case highlights the need to consider ocular syphilis as a great masquerader even in the presence of atypical presentations such as hemorrhagic retinitis. Syphilis should be tested for treponemal and non-treponemal tests, and it should be ruled out as an etiological agent in every case of new-onset intra-ocular inflammation.
梅毒曾被称为“伟大的模仿者”，因为感染后会出现多种疾病表现。眼部表现包括广泛的眼内炎症。
本研究报告了一例 52 岁男性梅毒出血性坏死性视网膜炎患者。
患者因视力迅速下降和眼部红肿持续三周而到急诊就诊，正在接受免疫抑制治疗。诊断为梅毒出血性坏死性视网膜炎，类似于免疫功能低下患者巨细胞病毒感染引起的视网膜炎的典型临床表现。
本病例强调即使出现非典型表现，如出血性视网膜炎，也应将眼部梅毒视为一种重要的伪装者。应进行梅毒螺旋体和非梅毒螺旋体检查，并排除梅毒作为新发眼内炎症的病因。
