Secundary ocular syphilis with chorioretinitis of the posterior pole - a case report

Background: Diagnosis of syphilis is often very difficult due to the absenc e of typical organ manifestation. In addition syphilis has the ability to i mitate any ocular inflammation. This may result in missdiagnosis and delay of appropriate antimicrobial therapy. Up to now the first choice therapy is penicillin. Case report: We report about an otherwise healthy, 40 year-old-woman, who w as referred to the Department of Ophthalmology, Universtity of Tuebingen, d ue to an unclear loss of visual acuitiy (OD 0.1 and OS 0.4). The fundus exa mination disclosed focal chorioretinitis on the posterior pole, which was v erified in fluorescein angiography. Secondary syphilis was diagnosed due to positive serological testing. Medical treatment consisted in Penicillin (i .m.) for 2 weeks and additional oral corticosteroids, which were tapered do wn slowly. After 3 months visual acuity had improved to 0.9 in the right an d to 1.0 in the left eye. The former chorioretinitis regions showed only hy perpigmentation. Conclusions: Laboratory syphilitic testing should be performed in every uve itis.