Skip to main content
Top
Published in: BMC Infectious Diseases 1/2012

Open Access 01-12-2012 | Case report

Chancre of the eyelid as manifestation of primary syphilis, and precocious chorioretinitis and uveitis in an HIV-infected patient: a case report

Authors: Salvatore Cillino, Francesco Di Pace, Marcello Trizzino, Valentina Li Vecchi, Paola Di Carlo

Published in: BMC Infectious Diseases | Issue 1/2012

Login to get access

Abstract

Background

Ocular syphilis is often difficult to diagnose because of the wide variation in clinical features.
HIV co-infection may further complicate the picture.

Case presentation

Herein the authors report an unusual primary syphilitic ocular lesion in a 45-year-old Italian HIV-infected bisexual man who presented with a unilateral eyelid lesion. Associated precocious signs and symptoms in the posterior segment of both eyes, bilateral chorioretinitis and uveitis, are described. Intravenous penicillin and steroid treatment produced a rapid improvement in clinical status and complete resolution.

Conclusions

Careful questioning about sexual behavior is crucial for unmasking unusual features of ocular syphilis in HIV-infected subjects.
Appendix
Available only for authorised users
Literature
1.
go back to reference Doris JP, Saha K, Jones NP, Sukthankar A: Ocular syphilis: the new epidemic. Eye (Lond). 2006, 20: 703-705. 10.1038/sj.eye.6701954.CrossRef Doris JP, Saha K, Jones NP, Sukthankar A: Ocular syphilis: the new epidemic. Eye (Lond). 2006, 20: 703-705. 10.1038/sj.eye.6701954.CrossRef
2.
go back to reference Gaudio PA: Update on ocular syphilis. Curr Opin Ophthalmol. 2006, 17: 562-566. 10.1097/ICU.0b013e328010a9b5.CrossRefPubMed Gaudio PA: Update on ocular syphilis. Curr Opin Ophthalmol. 2006, 17: 562-566. 10.1097/ICU.0b013e328010a9b5.CrossRefPubMed
3.
go back to reference Kent ME, Romanelli F: Reexamining syphilis: an update on epidemiology, clinical manifestations, and management. Ann Pharmacother. 2008, 42: 226-236. 10.1345/aph.1K086.CrossRefPubMed Kent ME, Romanelli F: Reexamining syphilis: an update on epidemiology, clinical manifestations, and management. Ann Pharmacother. 2008, 42: 226-236. 10.1345/aph.1K086.CrossRefPubMed
4.
go back to reference Chhablani JK, Biswas J, Sudharshan S: Panuveitis as a manifestation of ocular syphilis leading to HIV diagnosis. Oman J Ophthalmol. 2010, 3: 29-31. 10.4103/0974-620X.60019.CrossRefPubMedPubMedCentral Chhablani JK, Biswas J, Sudharshan S: Panuveitis as a manifestation of ocular syphilis leading to HIV diagnosis. Oman J Ophthalmol. 2010, 3: 29-31. 10.4103/0974-620X.60019.CrossRefPubMedPubMedCentral
5.
go back to reference Amaratunge BC, Camuglia JE, Hall AJ: Syphilitic uveitis: a review of clinical manifestations and treatment outcomes of syphilitic uveitis in human immunodeficiency virus-positive and negative patients. Clin Experiment Ophthalmol. 2010, 38: 68-74. 10.1111/j.1442-9071.2010.02203.x.CrossRefPubMed Amaratunge BC, Camuglia JE, Hall AJ: Syphilitic uveitis: a review of clinical manifestations and treatment outcomes of syphilitic uveitis in human immunodeficiency virus-positive and negative patients. Clin Experiment Ophthalmol. 2010, 38: 68-74. 10.1111/j.1442-9071.2010.02203.x.CrossRefPubMed
6.
go back to reference Ng DS, Wong IY, Chan CW: Re-emergence of syphilitic uveitis masquerading as other diseases: a report of two cases. Case Report Ophthalmol. 2011, 2: 266-272. 10.1159/000331202.CrossRef Ng DS, Wong IY, Chan CW: Re-emergence of syphilitic uveitis masquerading as other diseases: a report of two cases. Case Report Ophthalmol. 2011, 2: 266-272. 10.1159/000331202.CrossRef
7.
go back to reference Li JZ, Tucker JD, Lobo AM, Marra CM, Davis BT, Papaliodis GN, Felsenstein D, Durand ML, Yawetz S, Robbins GK: Ocular syphilis among HIV-infected individuals. Clin Infect Dis. 2010, 51: 468-471. 10.1086/654797.CrossRefPubMedPubMedCentral Li JZ, Tucker JD, Lobo AM, Marra CM, Davis BT, Papaliodis GN, Felsenstein D, Durand ML, Yawetz S, Robbins GK: Ocular syphilis among HIV-infected individuals. Clin Infect Dis. 2010, 51: 468-471. 10.1086/654797.CrossRefPubMedPubMedCentral
8.
go back to reference Workowski KA, Berman S: Centers for Disease Control and Prevention (CDC): Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010, 59 (RR-12): 1-110.PubMed Workowski KA, Berman S: Centers for Disease Control and Prevention (CDC): Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010, 59 (RR-12): 1-110.PubMed
9.
go back to reference Jeyakumar W, Chithra A, Shanmugasundararaj A: Primary syphilis of the eyelid: case report. Genitourin Med. 1989, 65: 192-193.PubMedPubMedCentral Jeyakumar W, Chithra A, Shanmugasundararaj A: Primary syphilis of the eyelid: case report. Genitourin Med. 1989, 65: 192-193.PubMedPubMedCentral
10.
go back to reference Koek AG, Bruisten SM, Dierdorp M, Van Dam AP, Templeton K: Specific and sensitive diagnosis of syphilis using a real-time PCR for Treponema pallidum. Clin Microbiol Infect. 2006, 12: 1233-1236. 10.1111/j.1469-0691.2006.01566.x.CrossRefPubMed Koek AG, Bruisten SM, Dierdorp M, Van Dam AP, Templeton K: Specific and sensitive diagnosis of syphilis using a real-time PCR for Treponema pallidum. Clin Microbiol Infect. 2006, 12: 1233-1236. 10.1111/j.1469-0691.2006.01566.x.CrossRefPubMed
11.
go back to reference Heymans R, van der Helm JJ, de Vries HJ, Fennema HS, Coutinho RA, Bruisten SM: Clinical value of Treponema pallidum real-time PCR for diagnosis of syphilis. J Clin Microbiol. 2010, 48: 497-502. 10.1128/JCM.00720-09.CrossRefPubMed Heymans R, van der Helm JJ, de Vries HJ, Fennema HS, Coutinho RA, Bruisten SM: Clinical value of Treponema pallidum real-time PCR for diagnosis of syphilis. J Clin Microbiol. 2010, 48: 497-502. 10.1128/JCM.00720-09.CrossRefPubMed
12.
go back to reference Singh AE, Romanowski B: Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. Clin Microbiol Rev. 1999, 12: 187-209.PubMedPubMedCentral Singh AE, Romanowski B: Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. Clin Microbiol Rev. 1999, 12: 187-209.PubMedPubMedCentral
13.
go back to reference Tucker JD, Li JZ, Robbins GK, Davis BT, Lobo AM, Kunkel J, Papaliodis GN, Durand ML, Felsenstein D: Ocular syphilis among HIV-infected patients: a systematic analysis of the literature. Sex Transm Infect. 2011, 87: 4-8. 10.1136/sti.2010.043042.CrossRefPubMed Tucker JD, Li JZ, Robbins GK, Davis BT, Lobo AM, Kunkel J, Papaliodis GN, Durand ML, Felsenstein D: Ocular syphilis among HIV-infected patients: a systematic analysis of the literature. Sex Transm Infect. 2011, 87: 4-8. 10.1136/sti.2010.043042.CrossRefPubMed
14.
go back to reference Balba GP, Kumar PN, James AN, Malani A, Palestine AG, Welch JN, Timpone JG: Ocular syphilis in HIV-positive patients receiving highly active antiretroviral therapy. Am J Med. 2006, 119 (448): e21-e25.PubMed Balba GP, Kumar PN, James AN, Malani A, Palestine AG, Welch JN, Timpone JG: Ocular syphilis in HIV-positive patients receiving highly active antiretroviral therapy. Am J Med. 2006, 119 (448): e21-e25.PubMed
15.
go back to reference Rocha G, Baines MG, Deschênes J: The immunology of the eye and its systemic interactions. Crit Rev Immunol. 1992, 12 (3–4): 81-100.PubMed Rocha G, Baines MG, Deschênes J: The immunology of the eye and its systemic interactions. Crit Rev Immunol. 1992, 12 (3–4): 81-100.PubMed
16.
go back to reference Puech C, Gennai S, Pavese P, Pelloux I, Maurin M, Romanet JP, Chiquet C: Ocular manifestations of syphilis: recent cases over a 2.5-year period. Graefes Arch Clin Exp Ophthalmol. 2010, 248: 1623-1629. 10.1007/s00417-010-1481-z.CrossRefPubMed Puech C, Gennai S, Pavese P, Pelloux I, Maurin M, Romanet JP, Chiquet C: Ocular manifestations of syphilis: recent cases over a 2.5-year period. Graefes Arch Clin Exp Ophthalmol. 2010, 248: 1623-1629. 10.1007/s00417-010-1481-z.CrossRefPubMed
17.
go back to reference McCall MB, van Lith-Verhoeven JJ, van Crevel R, Crama N, Koopmans PP, Hoyng CB, van der Ven AJ: Ocular syphilis acquired through oral sex in two HIV-infected patients. Neth J Med. 2004, 62: 206-208.PubMed McCall MB, van Lith-Verhoeven JJ, van Crevel R, Crama N, Koopmans PP, Hoyng CB, van der Ven AJ: Ocular syphilis acquired through oral sex in two HIV-infected patients. Neth J Med. 2004, 62: 206-208.PubMed
Metadata
Title
Chancre of the eyelid as manifestation of primary syphilis, and precocious chorioretinitis and uveitis in an HIV-infected patient: a case report
Authors
Salvatore Cillino
Francesco Di Pace
Marcello Trizzino
Valentina Li Vecchi
Paola Di Carlo
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2012
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-12-226

Other articles of this Issue 1/2012

BMC Infectious Diseases 1/2012 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.