Clinical and ophthalmologic characteristics of ocular syphilis in a retrospective tertiary hospital cohort.

Abstract:

BACKGROUND:Data on ocular syphilis (OS) and its clinical presentation are currently insufficient. This study aimed to investigate the characteristics of a cohort with a high OS incidence at a university hospital in Germany, focusing on clinical presentation of OS. METHODS:This single-center cohort study retrospectively analyzed data on 90 patients with 109 episodes of syphilis between 2008 and 2018. OS cases were identified and additionally re-evaluated through a study-specific secondary assessment by an ophthalmologist specializing in uveitis. RESULTS:Twenty-three patients (26%) were diagnosed with OS, 16 (70%) with binocular involvement. Uveitis, especially that of the posterior segment, showed a high prevalence. Lumbar puncture (LP) was performed in 20 OS patients (87%), of whom 17 (85% of those with LP /74% in total) met the 2018 Centers for Disease Control and Prevention criteria for likely neurosyphilis. Five of 23 patients (22%) had human immunodeficiency virus infection, of whom two did not receive antiretroviral therapy. The preferred syphilis treatment regimens were benzylpenicillin and ceftriaxone, which yielded favorable serological, clinical, and ophthalmological outcomes. CONCLUSIONS:A high incidence of OS was identified, and physicians should be aware of uveitis as a manifestation of syphilis. Most patients presented with uveitis and syphilis in an early or late latent stage and showed central nervous system involvement.

journal_name

Sex Transm Dis

authors

Wagner LF,Lanzl I,Rothe K,Schneider J,Zink A,Zapp D,Schwerdtfeger C,Lee M,Weidlich S,Neuenhahn M,Loos D,Spinner CD

doi

10.1097/OLQ.0000000000001329

subject

Has Abstract

pub_date

2020-11-04 00:00:00

eissn

0148-5717

issn

1537-4521

pub_type

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