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Unique Presentation of Syphilis With Ocular Involvement: A Case Report

Ocular syphilis could be the first sign of undiagnosed syphilis. In addition to otosyphilis, it can be observed in the primary, secondary, or tertiary stages of syphilis. Nonspecific clinical symptoms make diagnosis difficult. We report a patient who presented with generalized weakness and blurry vi...

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Autores principales: Dhillon, Gagandeep, Munjal, Ripudaman S, Grewal, Harpreet, Sharma, Pranjal, Kashyap, Rahul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250061/
https://www.ncbi.nlm.nih.gov/pubmed/37303323
http://dx.doi.org/10.7759/cureus.38793
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author Dhillon, Gagandeep
Munjal, Ripudaman S
Grewal, Harpreet
Sharma, Pranjal
Kashyap, Rahul
author_facet Dhillon, Gagandeep
Munjal, Ripudaman S
Grewal, Harpreet
Sharma, Pranjal
Kashyap, Rahul
author_sort Dhillon, Gagandeep
collection PubMed
description Ocular syphilis could be the first sign of undiagnosed syphilis. In addition to otosyphilis, it can be observed in the primary, secondary, or tertiary stages of syphilis. Nonspecific clinical symptoms make diagnosis difficult. We report a patient who presented with generalized weakness and blurry vision for the past four to five days. In this case, we emphasize the importance of repeated cerebrospinal fluid (CSF) examinations as they led to the diagnosis of ocular syphilis and appropriate neurosyphilis treatment. It must be suspected in patients with primary or secondary neurological symptoms, such as blurred vision and weakness. Treponema, the causative organism, is invisible under light microscopy and is mostly identified by its distinct spiral movements under darkfield microscopy. Once the diagnosis was made, the patient was started on penicillin treatment to prevent spread to the brain and dorsal spinal cord. The patient responded well to antibiotic treatment, with improvement in visual acuity, and was discharged with close neurological and ophthalmological follow-up. 
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spelling pubmed-102500612023-06-09 Unique Presentation of Syphilis With Ocular Involvement: A Case Report Dhillon, Gagandeep Munjal, Ripudaman S Grewal, Harpreet Sharma, Pranjal Kashyap, Rahul Cureus Internal Medicine Ocular syphilis could be the first sign of undiagnosed syphilis. In addition to otosyphilis, it can be observed in the primary, secondary, or tertiary stages of syphilis. Nonspecific clinical symptoms make diagnosis difficult. We report a patient who presented with generalized weakness and blurry vision for the past four to five days. In this case, we emphasize the importance of repeated cerebrospinal fluid (CSF) examinations as they led to the diagnosis of ocular syphilis and appropriate neurosyphilis treatment. It must be suspected in patients with primary or secondary neurological symptoms, such as blurred vision and weakness. Treponema, the causative organism, is invisible under light microscopy and is mostly identified by its distinct spiral movements under darkfield microscopy. Once the diagnosis was made, the patient was started on penicillin treatment to prevent spread to the brain and dorsal spinal cord. The patient responded well to antibiotic treatment, with improvement in visual acuity, and was discharged with close neurological and ophthalmological follow-up.  Cureus 2023-05-09 /pmc/articles/PMC10250061/ /pubmed/37303323 http://dx.doi.org/10.7759/cureus.38793 Text en Copyright © 2023, Dhillon et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Dhillon, Gagandeep
Munjal, Ripudaman S
Grewal, Harpreet
Sharma, Pranjal
Kashyap, Rahul
Unique Presentation of Syphilis With Ocular Involvement: A Case Report
title Unique Presentation of Syphilis With Ocular Involvement: A Case Report
title_full Unique Presentation of Syphilis With Ocular Involvement: A Case Report
title_fullStr Unique Presentation of Syphilis With Ocular Involvement: A Case Report
title_full_unstemmed Unique Presentation of Syphilis With Ocular Involvement: A Case Report
title_short Unique Presentation of Syphilis With Ocular Involvement: A Case Report
title_sort unique presentation of syphilis with ocular involvement: a case report
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250061/
https://www.ncbi.nlm.nih.gov/pubmed/37303323
http://dx.doi.org/10.7759/cureus.38793
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