Perforating Peripheral Ulcerative Keratitis in Syphilis

PURPOSE: To present a case of peripheral ulcerative keratitis with perforation in the setting of syphilis. METHOD: A single observational case report in urban USA. CASE PRESENTATION: A patient with multiple sexual partners presented with bilateral peripheral ulcerative keratitis, unilateral corneal perforation, and a pustular rash. Workup was positive for syphilis as well as HSV, HIV, and multiple autoantibody tests. Findings improved after treatment for syphilis. CONCLUSION: Bilateral peripheral ulcerative keratitis in syphilis has been reported in one prior case. However, corneal perforation in the setting of syphilis infection has not, to our knowledge, been reported previously.